Bernstein Wendy K, Goehner Nicholas
Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Department of Anesthesiology, Kaiser Permanente Wailuku, Maui Memorial Medical Center, Maui, HI, USA.
Case Rep Anesthesiol. 2019 Nov 5;2019:1562124. doi: 10.1155/2019/1562124. eCollection 2019.
Tricuspid rupture secondary to blunt force trauma is a rare diagnosis. However, the incidence of this injury is rising due to the improved initial treatment of complex trauma patients as well as enhanced early detection methods through the use of cardiac ultrasound. We report the case of an otherwise healthy 42 year old male who sustained significant blunt force trauma after a single motor vehicle accident. The diagnosis of traumatic papillary rupture and disruption of the valve apparatus was made on the day of admission after perioperative hemodynamic compromise and the use of intraoperative transesophageal echocardiography. However, treatment was delayed due to concerns of systemic anticoagulation leading to his eventual demise.
钝性暴力创伤继发三尖瓣破裂是一种罕见的诊断。然而,由于复杂创伤患者初始治疗的改善以及通过使用心脏超声增强了早期检测方法,这种损伤的发生率正在上升。我们报告一例42岁健康男性的病例,该患者在一次机动车事故中遭受了严重的钝性暴力创伤。在围手术期出现血流动力学不稳定并使用术中经食管超声心动图检查后,于入院当天诊断为创伤性乳头肌破裂和瓣膜装置破坏。然而,由于担心全身抗凝导致最终死亡,治疗被推迟。