Kikuchi Chizuo, Motohashi Shinya, Takahashi Yoshiki, Nakazawa Satoshi, Kanazawa Hiroshi
Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan.
Gen Thorac Cardiovasc Surg. 2015 Nov;63(11):616-9. doi: 10.1007/s11748-013-0322-5. Epub 2013 Sep 17.
A 63-year-old woman involved in an automobile accident was brought to our hospital with thoracic injury sustained by the impact of her vehicle's steering wheel. Cardiac auscultation revealed a grade III/VI systolic murmur and the electrocardiogram showed ST elevation in leads 2, 3 and aVF. A 2D echocardiogram revealed severe tricuspid regurgitation and a hypokinetic right ventricle. Coronary angiography revealed dissection of the proximal right coronary artery (RCA) with 90 % stenosis. Urgent CABG for the RCA and tricuspid valvuloplasty were performed, as the anterior leaflet of the tricuspid valve had prolapsed as a result of chordal rupture. Blunt thoracic trauma causing both tricuspid insufficiency and coronary artery dissection is a very rare and life-threatening situation. Prompt diagnosis and timely surgery enabled us to save this patient's life.
