[Traumatic tricuspid insufficiency. Clinical and therapeutic aspects. Report of three cases (author's transl)].

Three cases of traumatic tricuspid insufficiency are reported. The most consistent clinical and noninvasive cardiovascular findings were: previous nonpenetrating thorax trauma; non holosystolic murmur which increased slightly during inspiration on standing; electrocardiographic patterns of right atrial enlargement and right bundle branch block; unusual bulge along the mid-left heart border, seen on chest x-ray examination suggesting ventricular aneurysm; striking right ventricular dilatation wit paradoxical movement of the ventricular septum on ECHO. Cardiac catheterization led to definitive diagnosis by demonstrating a massive tricuspid valve incompetence with "ventricularisation" of the right atrial pressure. Some dyskinetic areas of the right ventrice, most likely due to the full-thickness contusion of the miocardial wall, seen on the right cineangiography, confirmed the diagnosis. The long-term clinical and haemodynamic follow-up was useful for monitoring the evolution of the disease. Surgery should be recommended in the presence of right-sided heart failure not relieved by adequate medical treatment, in view of the low operative risk.