Successful repair of tricuspid regurgitation 46 years after causal blunt trauma

Cardiac Injury After All-Terrain Vehicle Accidents in 2 Children and a Review of the Literature

All-terrain vehicle (ATV) accidents leading to severe morbidity and mortality are common. At our institution, 2 children presented within weeks of each other after ATV accidents. Both children required cardiac valve surgery. The surgical management of these 2 children is discussed, and the literature is reviewed. On initial patient presentation, the diagnosis of a ruptured cardiac valve or ventricular septal defect (VSD) associated with these types of accidents is often delayed. We propose that patients presenting with evidence of high-energy blunt thoracic trauma after an ATV accident should undergo an electrocardiogram, cardiac enzyme assessment, and cardiac echocardiogram as part of the initial work-up to rule out significant myocardial injury.

Simultaneous aortic and tricuspid valve rupture after fall injury

This case study concerns a patient with disruption of both tricuspid and aortic valves: a previously healthy, adult man, who sustained a 5-meter fall from a building under construction. The mechanism of the injury was acceleration and deceleration, acting in two different phases of the cardiac cycle, i.e. systole and diastole. Simultaneous occurrence of these injuries is exceedingly rare and in a careful literature review, we did not find any such combination of injury. The possible mechanisms of this injury, as well as surgical techniques are discussed.

A case of traumatic tricuspid regurgitation caused by multiple papillary muscle rupture

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma. With the increase in the number of automobile accidents, traumatic tricuspid regurgitation has become an important problem after blunt chest trauma. It has been reported more frequently because of better diagnostic procedures and a better understanding of the pathology. The early diagnosis of traumatic tricuspid regurgitation is important because traumatic tricuspid injury could be effectively corrected with reparative techniques, early operation is considered to relieve symptoms and to prevent right ventricular dysfunction. Echocardiography can reveal the cause and severity of regurgitation. We experienced a case of tricuspid regurgitation after blunt chest trauma early diagnosis and valve repair were performed. This case reminds the physicians in the emergency department should be aware of this potential complication following non-penetrating chest trauma and echocardiography is useful and should play an early role.

Traumatic pericardial rupture involved with complication by blunt chest trauma

A 65-year-old man who had sustained a blunt chest trauma in a traffic accident demonstrated a mass in the left hilum by chest radiography. Emergency surgery demonstrated a rupture of the left-side pericardium with herniation of the heart into the left pleural cavity along with a right ventricular rupture. The tear in the right ventricle was sutured using 4-0 polypropylene with felt and the pericardial rupture was repaired with an expanded polytetrafluoroethylene sheet. A 31-year-old man who had been crushed against a tree while skiing 5 years and 6 months earlier was diagnosed as having severe tricuspid valve regurgitation and tricuspid valve replacement was performed. Large left pericardial defect was found and repaired with an equine pericardial patch. In both cases, a bridging of phrenic nerve was found in the pericardial defect that was regarded as a traumatic rupture.

Traumatic tricuspid insufficiency--a case report

Traumatic tricuspid insufficiency following blunt chest trauma, although an uncommon entity, has been reported more frequently over the past 2 decades. Increased physician awareness of the possibility of myocardial trauma accompanied by proper clinical evaluation and follow-up are the keys to a successful outcome regardless of whether a medical or surgical approach to treatment is initially selected. Early surgical correction has become the preferred treatment in most instances and may be influenced by clinical status and other associated comorbid conditions. A patient with a combination of myocardial contusion, valve laceration, and papillary muscle rupture is presented.

Conservative surgical treatment of valvular injury after blunt chest trauma

BACKGROUND

Blunt injury to the cardiac valves leads to progressive ventricular failure often requiring surgical management. Most frequently, prosthetic replacement is the chosen management.

METHODS

Three consecutive patients presenting to one surgeon with blunt traumatic valve lesions formed the study group.

RESULTS

At operation, the valvular pathology was assessed, and reparative techniques were used to correct the defects. All the patients had an excellent outcome at follow-up periods of 2 to 3 years.

CONCLUSIONS

Conservative operation to repair traumatic valve lesions is feasible and has potential advantages over replacement.