Traumatic Cardiac Rupture at the Superior Vena Cava-Right Atrial Junction in Four Pediatric Patients: A Case Series in China National Children’s Medical Center

This case series reports 4 paediatric patients (aged 2-11 years old) who sustained traumatic cardiac rupture following blunt trauma, all of whom were successfully treated at our institution. In contrast to common adult presentations, each case featured a rupture localized specifically to the superior vena cava-right atrial (SVC-RA) junction. Diagnosis was confirmed by echocardiography in the presence of cardiac tamponade. All patients underwent urgent median sternotomy, during which primary repair was accomplished without cardiopulmonary bypass. Postoperatively, both shock index and mean arterial pressure showed significant improvement (P = .003 and P = .028, respectively), and all children recovered fully without complications. This series highlights the SVC-RA junction as a uniquely vulnerable site in paediatric blunt cardiac injury and demonstrates that rapid diagnosis coupled with timely surgical intervention is paramount for survival.