Ventre F, Bertinchant J P, Noblet D, Frapier J M, Carabasse D, Nigond J, Ledermann B, Cohen S, Joubert P, Grolleau-Raoux R
Service de cardiologie, CHU de Nîmes.
Arch Mal Coeur Vaiss. 1995 Jun;88(6):895-8.
The authors report two cases of tricuspid regurgitation by a ruptured anterior papillary muscle secondary to non-penetrating thoracic trauma. In the presence of suggestive clinical and electrocardiographic abnormalities (systolic murmur, right heart failure, right bundle branch block), echocardiography confirmed the tricuspid regurgitation, showed its mechanism and excluded any other intracardiac lesions. Tricuspid annuloplasty was performed in both cases because of the persistence of failure or degradation of the patient's clinical condition. Peroperative echocardiography was used to judge the quality of the surgical repair in both cases. Traumatic tricuspid regurgitation is a rare condition and the diagnosis is often delayed. Echocardiography is the investigation of choice and guides treatment which is essentially valvular repair in symptomatic patients.
作者报告了两例因非穿透性胸部创伤继发前乳头肌破裂导致的三尖瓣反流病例。在存在提示性临床和心电图异常(收缩期杂音、右心衰竭、右束支传导阻滞)的情况下,超声心动图证实了三尖瓣反流,显示了其机制并排除了任何其他心内病变。由于患者临床状况持续恶化或衰竭,两例均进行了三尖瓣环成形术。术中超声心动图用于判断两例手术修复的质量。创伤性三尖瓣反流是一种罕见疾病,诊断往往延迟。超声心动图是首选检查方法,指导有症状患者的治疗,主要是瓣膜修复。