Traumatic tricuspid valve insufficiency

Experience in thirteen patients

J. A M Van Son, G. K. Danielson, Hartzell V Schaff, Fletcher A Jr. Miller

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121 Citations (Scopus)

Abstract

From 1964 through June 1993, thirteen patients with traumatic tricuspid insufficiency were treated surgically; all were male, and the ages ranged from 17 to 64 years (median 39 years). The condition was associated with blunt chest trauma in all patients: motor vehicle accidents in twelve and an explosion of a tank of compressed air in one. The median duration between trauma and operation was 17 years (range 1 month to 37 years). Preoperatively, six patients were in sinus rhythm and seven were in atrial fibrillation. At operation, the right ventricular function appeared moderately to severely depressed in twelve patients. In twelve patients, the anterior leaflet was flail because of chordal rupture (n = 9), rupture of anterior papillary muscle (n = 3), or tear in the anterior leaflet (n = 1). In one patient, the septal leaflet was missing and in another it was retracted and adherent to the ventricular septum. In five patients the tricuspid valve was repaired and in eight it was replaced. In seven patients in the latter group, the chordae, papillary muscles, and/or tricuspid valve leaflet(s) were found to be in a contracted and atrophic state, precluding repair. No early or late deaths occurred. At follow-up extending to 26 years (median 12 years), 12 patients are in New York Heart Association class I and one patient is in class II. Nine patients were in sinus rhythm and four were in atrial fibrillation. Although our experience indicates that good functional results can still be achieved many years after the onset of traumatic tricuspid valve insufficiency, earlier diagnosis and surgical treatment should increase the feasibility of tricuspid valve repair, prevent progressive deterioration of right ventricular function, and increase the possibility of maintaining late sinus rhythm in a greater number of patients.

Original languageEnglish (US)
Pages (from-to)893-898
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume108
Issue number5
StatePublished - 1994

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Tricuspid Valve Insufficiency
Tricuspid Valve
Right Ventricular Function
Papillary Muscles
Atrial Fibrillation
Rupture
Compressed Air
Ventricular Septum
Explosions
Wounds and Injuries
Motor Vehicles
Tears
Accidents
Early Diagnosis
Thorax

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Traumatic tricuspid valve insufficiency : Experience in thirteen patients. / Van Son, J. A M; Danielson, G. K.; Schaff, Hartzell V; Miller, Fletcher A Jr.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 108, No. 5, 1994, p. 893-898.

Research output: Contribution to journalArticle

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