Late-Onset Right Heart Failure With Tricuspid Regurgitation Due to Cardiac Herniation After Blunt Thoracic Trauma.

BACKGROUND

Blunt thoracic trauma is a rare and potentially fatal condition, often treated acutely with minimal chronic phase reports.

CASE SUMMARY

A 63-year-old man with severe traumatic tricuspid regurgitation (TR), cardiac herniation, and heart constriction due to pericardial rupture suffered cardiac deformation and right heart failure 30 years after the trauma. Despite initial treatment, his symptoms worsened, prompting a referral for surgery. Chordal ruptures of the anterior tricuspid leaflets were observed intraoperatively. We performed tricuspid valve replacement and enlarged the pericardial defect to avoid constriction.

DISCUSSION

This case highlights the fact that cardiac herniation and traumatic tricuspid regurgitation after blunt trauma can lead to irregular heart enlargement and right-sided heart failure during the chronic phase. There is no established treatment, and this report may provide an effective treatment strategy.

TAKE-HOME MESSAGE: Surgical intervention can be effective for heart failure and ventricular deformation in chronic complications of blunt thoracic trauma.