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Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report.

Acar B, Suleymanoglu M, Burak C, Demirkan BM, Guray Y, Tufekcioglu O, Aydogdu S - J Tehran Heart Cent (2015)

Bottom Line: We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident.The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication.The patient had no problem according to the follow-up one month and six months after operation.

View Article: PubMed Central - PubMed

Affiliation: Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.

ABSTRACT
Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation.

No MeSH data available.


Related in: MedlinePlus

Transthoracic three-dimensional echocardiography view of tricuspid valve from the atrial aspect at ventricular systole showing destructed anterior and posterior leaflets of the tricuspid valve (arrows) and coaptation defect.Ao, Aorta; MV, Mitral valve; TV, Tricuspid valve; A, Anterior leaflet of the tricuspid valve; P, Posterior leaflet of the tricuspid valve
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Figure 4: Transthoracic three-dimensional echocardiography view of tricuspid valve from the atrial aspect at ventricular systole showing destructed anterior and posterior leaflets of the tricuspid valve (arrows) and coaptation defect.Ao, Aorta; MV, Mitral valve; TV, Tricuspid valve; A, Anterior leaflet of the tricuspid valve; P, Posterior leaflet of the tricuspid valve

Mentions: A 48-year-old female patient was admitted to our hospital with shortness of breath and extreme fatigue during daily activities, previously diagnosed as hypertension and controlled with medication. She had a history of a blunt trauma to her chest in a car accident 13 years earlier. There was a holosystolic murmur (grade 3) in the fourth intercostal space at the left sternal border, which increased with inspiration, as well as pretibial edema and jugular venous distention during physical examination. Electrocardiography showed atrial fibrillation and right bundle branch block. Flail tricuspid valve, right ventricular volume overload, and reduced right ventricular function were determined by 2-D TTE (Figure 1), and severe TR was established by Doppler echocardiography (Figure 2). Further examinations were performed via 3-D TTE to define the exact pathology of the valve (Figures 3 and 4). Both posterior and anterior leaflets were flail, and there was a coaptation defect. In addition, severely dilated right atrium and right ventricle were detected. All of the tricuspid leaflets were affected. Because of the chronicity of the lesion, the leaflets were thickened and their movements were restricted, probably owing to the chronic inflammation and fibrosis of the leaflets and the subvalvular apparatus. Based on these echocardiographic findings and the patient’s complaints, tricuspid valve replacement was planned. The valve was not suitable for repair, and bioprosthetic valve implantation was performed successfully. The patient was discharged without postoperative complications.


Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report.

Acar B, Suleymanoglu M, Burak C, Demirkan BM, Guray Y, Tufekcioglu O, Aydogdu S - J Tehran Heart Cent (2015)

Transthoracic three-dimensional echocardiography view of tricuspid valve from the atrial aspect at ventricular systole showing destructed anterior and posterior leaflets of the tricuspid valve (arrows) and coaptation defect.Ao, Aorta; MV, Mitral valve; TV, Tricuspid valve; A, Anterior leaflet of the tricuspid valve; P, Posterior leaflet of the tricuspid valve
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494520&req=5

Figure 4: Transthoracic three-dimensional echocardiography view of tricuspid valve from the atrial aspect at ventricular systole showing destructed anterior and posterior leaflets of the tricuspid valve (arrows) and coaptation defect.Ao, Aorta; MV, Mitral valve; TV, Tricuspid valve; A, Anterior leaflet of the tricuspid valve; P, Posterior leaflet of the tricuspid valve
Mentions: A 48-year-old female patient was admitted to our hospital with shortness of breath and extreme fatigue during daily activities, previously diagnosed as hypertension and controlled with medication. She had a history of a blunt trauma to her chest in a car accident 13 years earlier. There was a holosystolic murmur (grade 3) in the fourth intercostal space at the left sternal border, which increased with inspiration, as well as pretibial edema and jugular venous distention during physical examination. Electrocardiography showed atrial fibrillation and right bundle branch block. Flail tricuspid valve, right ventricular volume overload, and reduced right ventricular function were determined by 2-D TTE (Figure 1), and severe TR was established by Doppler echocardiography (Figure 2). Further examinations were performed via 3-D TTE to define the exact pathology of the valve (Figures 3 and 4). Both posterior and anterior leaflets were flail, and there was a coaptation defect. In addition, severely dilated right atrium and right ventricle were detected. All of the tricuspid leaflets were affected. Because of the chronicity of the lesion, the leaflets were thickened and their movements were restricted, probably owing to the chronic inflammation and fibrosis of the leaflets and the subvalvular apparatus. Based on these echocardiographic findings and the patient’s complaints, tricuspid valve replacement was planned. The valve was not suitable for repair, and bioprosthetic valve implantation was performed successfully. The patient was discharged without postoperative complications.

Bottom Line: We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident.The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication.The patient had no problem according to the follow-up one month and six months after operation.

View Article: PubMed Central - PubMed

Affiliation: Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.

ABSTRACT
Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation.

No MeSH data available.


Related in: MedlinePlus