Barbosa Fernando Martín, Quiroga José María, Otero Andrés Enrique, Girela German Alejandro
Department of Cardiovascular Surgery, South Cardiovascular Institute, Cipolletti, Rio Negro, Argentina.
Interact Cardiovasc Thorac Surg. 2011 Dec;13(6):653-4. doi: 10.1510/icvts.2011.275297. Epub 2011 Sep 11.
Aortic valve perforation due to a penetrating cardiac injury is extremely rare, especially with an associated shunt between the right ventricle and the aortic valve. We report here the case of an 18-year-old male, who after suffering a chest stab injury, was seen at another institution where he underwent an emergency left anterolateral thoracotomy and right ventricular suture. During the following 30 days, his course was torpid, complicated by a ventilator-associated pneumonia and heart failure with acute pulmonary edema. Workup confirmed the presence of an acute aortic regurgitation due to perforation of the right coronary leaflet with an interventricular shunt. After implementing appropriate medical treatment, the valve was replaced with a mechanical prosthesis and the shunt was closed with an autologous pericardial patch.
穿透性心脏损伤导致主动脉瓣穿孔极为罕见，尤其是合并右心室与主动脉瓣之间存在分流的情况。我们在此报告一例18岁男性病例，该患者胸部刺伤后在另一家机构就诊，在那里接受了急诊左前外侧开胸手术及右心室缝合术。在接下来的30天里，他病情进展缓慢，并发呼吸机相关性肺炎和伴有急性肺水肿的心力衰竭。检查证实因右冠状动脉瓣叶穿孔伴室间分流导致急性主动脉瓣反流。在采取适当的药物治疗后，用机械瓣膜替换了病变瓣膜，并用自体心包补片封闭了分流。
