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

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Kosin Med J. 2015;30(2):159-162

Publication date (electronic) : 2015 January 20

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

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 2014 April 17; 2015 January 02; Accepted 2015 February 24.

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

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.

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Fig. 1.

Fig. 2.

Fig. 3.

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