Weixler Viktoria H M, Aldana-Aguirre Jose, Zaulan Oshri, Chin Vannessa, Guerguerian Anne-Marie, Mertens Luc, Honjo Osami
Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.
Division of Cardiology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
JACC Case Rep. 2025 Jul 30;30(21):104350. doi: 10.1016/j.jaccas.2025.104350.
We present 2 cases of traumatic ventricular septal defects (VSDs), both caused by horse kick injuries. Given this rare but critical condition, we decided to share our experiences and the lessons learned managing these cases.
The first patient, a 12-year-old girl, was trampled by a horse, sustained a traumatic apical ventricular septal defect with pseudoaneurysm, was stabilized first, and underwent surgical closure 19 days after the injury. The second patient, a 9-year-old girl, was kicked by a horse in the chest; developed profound cardiogenic shock; and was found to have multiple large muscular VSDs, biventricular dysfunction, and pulmonary edema requiring emergent repair.
Presentation of traumatic VSDs can vary, ranging from a stable patient to a patient presenting in cardiogenic shock. Immediate closure is not without risks but may be the only option in some cases.
TAKE-HOME MESSAGE: Outcomes of traumatic VSDs are excellent, although emergent VSD closure might be necessary.
