Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Traumatic Tricuspid Regurgitation Cause by Chordal Rupture: A Case Report

건삭 파열에 의한 외상성 삼천판 역류: 증례보고

  • Keum, Min Ae (Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • No, Hyo Keun (Department of General Surgery, Armed Forces Capital Hospital) ;
  • Sun, Byung Joo (Division of Cardiology, Department of Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital) ;
  • Hong, Suk-Kyung (Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center)
  • 금민애 (울산대학교 의과대학 서울아산병원 외과학교실 외상 및 중환자외과) ;
  • 노효근 (국군수도병원 외과) ;
  • 선병주 (충남대학교 의과대학 충남대학교병원 내과학교실 심장내과) ;
  • 홍석경 (울산대학교 의과대학 서울아산병원 외과학교실 외상 및 중환자외과)
  • Received : 2014.12.24
  • Accepted : 2015.05.15
  • Published : 2015.06.30
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Abstract

Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.

Keywords

References

  1. George Karatasakis. Cardiac emergencies: Blunt chest trauma. Srce i krvni sudovi. 2013; 32: 192-4. https://doi.org/10.5937/siks1303192K
  2. Ismailov RM, Weiss HB, Ness RB, Lawrence BA, Miller TR. Blunt cardiac injury associated with cardiac valve insufficiency: Trauma links to chronic disease? Injury 2005; 36: 1022-8. https://doi.org/10.1016/j.injury.2005.05.028
  3. Perlroth MG, Hazan E, Lecompte Y, Gougne G. Chronic tricuspid regurgitation and bifascicular block due to blunt chest trauma. Am J Med Sci 1986; 291: 119-25. https://doi.org/10.1097/00000441-198602000-00008
  4. Krasna MJ, Flancbaum L. Blunt cardiac trauma: clinical manifestations and management. Semin Thorac Cardiovasc Surg 1992; 4: 195-202.
  5. Banning, A.P., Durrani, A., Pillai, R. Rupture of the atrial septum and tricuspid valve after blunt chest trauma. Ann. Thorac. Surg 1997; 64: 240-2. https://doi.org/10.1016/S0003-4975(97)00275-0
  6. Bardy, G.H., Talano, J.V., Meyers, S., Lesch, M. Acquired cyanotic heart disease secondary to traumatic tricuspid regurgitation: Case report with a review of the literature. Am J Cardiol 1979; 44: 1401-6. https://doi.org/10.1016/0002-9149(79)90460-0
  7. J. Reiss, Anees J. Razzouk, J Kiev, Ramesh Bansal, Leonard L. Bailey. Concomitant Traumatic Coronary Artery and Tricuspid Valve Injury: A Heterogenous Presentation. J Trauma Injury, Infection and Critical care 2001; 50: 942-4. https://doi.org/10.1097/00005373-200105000-00031
  8. Sybrandy KC, Cramer MJ, Burersdijk C. Diagnosing cardiac contusion: old wisdom and new insights. Heart 2003; 89: 485-9. https://doi.org/10.1136/heart.89.5.485
  9. Salim A, Velmahos GC, Jindal A, Chan L, Vassiliu P, Belzberg H. Clinically significant blunt cardiac trauma: role of serum troponin levels combined with electrocardiographic findings. J Trauma 2001; 50: 237-43. https://doi.org/10.1097/00005373-200102000-00008
  10. Velmahos GC, Karaiskakis M, Salim A, Toutouzas KG, Murray J, Asensio J. Normal electrocardiography and serum troponin I levels preclude the presence of clinically significant blunt cardiac injury. J Trauma 2003; 54: 45-50. https://doi.org/10.1097/00005373-200301000-00006
  11. van Son, J.A.M., Danielson, G.K., Schaff, H.V., Miller, F.A. Traumatic tricuspid insufficiency. Experience in thirteen patients. J Thorac Cardiovasc. Surg 1994; 108: 893-8. https://doi.org/10.1016/S0022-5223(94)70188-1
  12. Ma WG, Luo GH, Sun HS, Xu JP, Hu SS, Zhu XD. Surgical treatment of traumatic tricuspid insufficiency: experience in 13 cases. Ann Thorac Surg 2010; 90: 1934-8. https://doi.org/10.1016/j.athoracsur.2010.07.081