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http://dx.doi.org/10.20408/jti.2020.0060

Delayed Diagnosis of Traumatic Rupture of Anterior Papillary Muscle of Tricuspid Valve; Importance of Trans-Esophageal Echocardiogram in the Evaluation of Major Blunt Chest Trauma  

Bylsma, Ryan (Department of Cardiothoracic Surgery, Loma Linda University Medical Center)
Baldawi, Mustafa (Department of Cardiothoracic Surgery, Loma Linda University Medical Center)
Toporoff, Bruce (Department of Cardiothoracic Surgery, Loma Linda University Medical Center)
Shin, Matthew (Department of Cardiothoracic Surgery, Loma Linda University Medical Center)
Cochran-Yu, Meghan (Division of Acute Care Surgery, Department of General Surgery, Loma Linda University Medical Center)
Ramsingh, Davinder (Department of Anesthesia & Critical Care, Loma Linda University Medical Center)
Parwani, Purvi (Division of Cardiology, Department of Medicine, Loma Linda University Medical Center)
Rabkin, David G. (Department of Cardiothoracic Surgery, Loma Linda University Medical Center)
Publication Information
Journal of Trauma and Injury / v.34, no.2, 2021 , pp. 136-140 More about this Journal
Abstract
We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.
Keywords
Blunt injury; Tricuspid regurgitation; Transesophageal echocardiography;
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1 Gayet C, Pierre B, Delahaye JP, Champsaur G, Andre-Fouet X, Rueff P. Traumatic tricuspid insufficiency. An underdiagnosed disease. Chest 1987;92:429-32.   DOI
2 van Son JA, Danielson GK, Schaff HV, Miller FA Jr. Traumatic tricuspid valve insufficiency. Experience in thirteen patients. J Thorac Cardiovasc Surg 1994;108:893-8.   DOI
3 Nelson M, Wells G. A case of traumatic tricuspid valve regurgitation caused by blunt chest trauma. J Am Soc Echocardiogr 2007;20:198.e4-5.   DOI
4 Kulshrestha P, Das B, Iyer KS, Sampath KA, Sharma ML, Rao IM, et al. Cardiac injuries--a clinical and autopsy profile. J Trauma 1990;30:203-7.   DOI
5 Leichtle SW, Singleton A, Singh M, Griffee MJ, Tobin JM. Transesophageal echocardiography in the evaluation of the trauma patient: a trauma resuscitation transesophageal echocardiography exam. J Crit Care 2017;40:202-6.   DOI
6 Aukema TS, Beenen LF, Hietbrink F, Leenen LP. Validation of the thorax trauma severity score for mortality and its value for the development of acute respiratory distress syndrome. Open Access Emerg Med. 2011;3:49-53.
7 Banning AP, Durrani A, Pillai R. Rupture of the atrial septum and tricuspid valve after blunt chest trauma. Ann Thorac Surg 1997;64:240-2.   DOI
8 Griffee MJ, Singleton A, Zimmerman JM, Morgan DE, Nirula R. The effect of perioperative rescue transesophageal echocardiography on the management of trauma patients. A A Case Rep 2016;6:387-90.   DOI
9 Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma 1997;43:922-5.   DOI
10 Veysi VT, Nikolaou VS, Paliobeis C, Efstathopoulos N, Giannoudis PV. Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience. Int Orthop 2009;33:1425-33.   DOI
11 Baker L, Almadani A, Ball CG. False negative pericardial focused assessment with sonography for trauma examination following cardiac rupture from blunt thoracic trauma: a case report. J Med Case Rep 2015;9:155.   DOI
12 Committee on Trauma. ATLS advanced trauma life support 10th edition student course manual. Chicago:American College of Surgeons;2018.