CASE REPORTS  CARDIAC PAPERS 

The Journal of Cardiovascular Surgery 1998 October;39(5):663-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Traumatic tricuspid regurgitation complicating endocarditis and right-to-left intracardiac shunt. A case report of successful operation

Liu Y. B., Ho Y. L., Lin F. Y., Lee Y. T.

From the Section of Cardiology Department of Internal Medicine and * Department of Surgery National Taiwan University Hospital, Taipei, Taiwan

Tri­cuspid regur­gi­ta­tion ­caused by ­blunt ­chest ­trauma is gen­er­ally ­quite tol­er­able for a ­long ­time in a clin­ical set­ting. ­This ­article ­reports on a 68-­year-old ­patient suf­fering ­from pro­gres­sive ­dyspnea ­after a ­blunt ­chest ­trauma ­having ­occurred 5 ­months pre­vi­ously. Flu-­like symp­toms ­occurred for sev­eral ­days ­before ­severe res­pir­a­tory dis­tress ­began ­upon the day of admis­sion. Tran­se­soph­a­geal echoc­ar­di­o­graphic evi­dence of endo­car­ditis and ­right-to-­left ­shunt ­across a ­patent ­foramen ­ovale (PFO) was dem­on­strated. Trau­matic tri­cuspid insuf­fi­ciency in ­this ­case was com­pli­cated ­with infec­tive endo­car­ditis and ­right-to-­left intra­car­diac ­shunt. Cya­notic con­ges­tive ­heart ­failure ­occurred sud­denly. He under­went emer­gency sur­gical ­repair ­with suc­cess. ­Based on the ­results pre­sented ­herein, we rec­om­mend ­that ­early diag­nosis be ­made for trau­matic regur­gi­ta­tion and endo­car­ditis by ech­o­car­di­og­raphy so as to ­ensure ther­a­peutic inter­ven­tion.