Post-traumatic tricuspid regurgitation with anterior papillary muscle rupture, corrected by papillary muscle reimplantation

Hae Young Lee; Sung Ho Cho; Jong In Kim

doi:10.7180/kmj.2015.30.2.159

Journal List > Kosin Med J > v.30(2) > 1057048

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Cho, and Kim: Post-traumatic tricuspid regurgitation with anterior papillary muscle rupture, corrected by papillary muscle reimplantation

Case Report

Kosin Medical Journal 2015;30(2):159-162.

Published online: 20 January 2015

DOI: https://doi.org/10.7180/kmj.2015.30.2.159

Post-traumatic tricuspid regurgitation with anterior papillary muscle rupture, corrected by papillary muscle reimplantation

Hae Young Lee, Sung Ho Cho, Jong In Kim

Department of Thoracic & Cardiovase Surgery, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Hae Young Lee, Department of Thoracic & Cardiovase Surgery, College of Medicine, Kosin University, 262, Gamcheon-ro, Seo-gu, Busan 49267, Korea TEL: +82-51-990-6466 FAX: +82-51-990-3066 E-mail: aorta007@naver.com

Received 17 April 20142 January 2015 Accepted 24 February 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 60-year-old male patient with blunt chest trauma was transferred to our facility because of unstable vital signs and pericardial effusion. These conditions occurred after orthopedic surgery to repair multiple left finger fractures at a local medical center. Trans-thoracic echocardiography showed severe tricuspid regurgitation and he underwent papillary muscle reimplantation and tricuspid annuloplasty open heart surgery for post-traumatic tricuspid regurgitation with anterior papillary muscle rupture. We report early surgical traumatic valve disease correction without complications.

Keywords: 1. Heart valves, papillary muscles, 2. Trauma, blunt 3. Tricuspid valve insufficiency 4. Tricuspid valve, repair

References

1. Gayet C, Pierre B, Delahaye JP, Champsaur G, Fouet XA, Rueff P. Traumatic tricuspid insufficiency: An underdiagnosed Disease. Chest. 1987; 92:429–32.

2. WG Ma, GH Luo, HS Sun, JP Xu, SS Hu, XD Zhu. Surgical treatment of traumatic tricuspid insufficiency: experience in 13 cases. Ann Thorac Surg. 2010; 90:1934–8.

3. Maisano F, Lorusso R, Sandrelli L, Torracca L, Coletti G, Canna G, et al. Valve repair for traumatic tricuspid regurgitation. Eur J Cardiothorac Surg. 1996; 10:867–73.

4. Matthew J. Wall, Jr, Ernesto R. Soltero. Trauma to cardiac valves. Current opinion in cardiology. 2002; 17:188–92.

5. Naja I, Pomar JL, Barriuso C, Mestrea C, Mulet J. Traumatic tricuspid regurgitation. J Cardiovasc Surg (Torino). 1992; 33:256–7.

6. Shapiro MJ, Yanofsky SD, Trapp J, Durham RM, Labovitz A, Sear JE, et al. Cardiovascular evaluation in blunt thoracic trauma using transesophageal echocardiography. 1991; 31:835–40.

7. Bang JH, Woo JS, Choi PJ, Park KJ, Jeong SS, Yi JH. Repair of ruptured papillary muscle of the tricuspid valve as a cause of tricuspid insufficiency following blunt chest trauma. Korean J Thorac Cardiovasc Surg. 2010; 43:413–6.

8. De Bonis M, Lapenna E, La Canna G, Grimaldi A, Maisano F, Torracca L, et al. A novel technique for correction of severe tricuspid valve regurgitation due to complex lesions. Eur J Cardiothorac Surg. 2004; 25:760–5.

Fig. 1.

Chest computed tomography scan showed small amounts of pericardial effusion anterior to the right ventricle and right pleural effusion(A). Echocardiography showed that the tricuspid valve anterior leaflet had flailed papillary muscle(arrow)(B). Doppler echocardiography showed severe regurgitant flow at the right atrioventricular level during systole(C).

Fig. 2.

Intraoperative gross findings: Ruptured papillary muscle (PM) of the tricuspid valve anterior leaflet(arrow)(A), right ventricle ruptured PM stump(arrow)(B), and PM reimplantation and tricuspid annuloplasty with a 33mm Duranring(C).

Fig. 3.

Echocardiography showed well coapted tricuspid valve leaflets(arrow) at the 7^th postoperative day.

TOOLS

Similar articles