ABSTRACT
Patients with cardiac rupture due to blunt trauma have more than 50% mortality rate and most of them expire before they arrive at the hospital emergency room. Since patients typically present with cardiac tamponade, the diagnosis can be easily confirmed with physical examination, echocardiography, and chest CT scan. However, in our case of the massive hemothorax on right side without evidence of cardiac tamponade, the diagnosis for cardiac rupture does not seems to be easy. Therefore, we must assume the probability of cardiac rupture if we plan an explo-thoracotomy in a patients with massive right hemothorax without rib fracture. We describe two cases of cardiac rupture combined with pericardial laceration and right massive hemothorax by blunt chest trauma. The ruptured hearts of the patients were successfully closed using cardio-pulmonary bypass or cell saver system without detrimental sequelae.