Obadia J F, Tatou E, David M
Thoracic and Cardiovascular Surgery, CHU, Lyon, France.
Br Heart J. 1995 Nov;74(5):545-7. doi: 10.1136/hrt.74.5.545.
Aortic valve regurgitation is an uncommon consequence of closed chest injury. It is caused by damage to the valve apparatus (ruptured cusp) or when subadventitial rupture of the ascending aorta causes prolapse of a subjacent valve cusp. Aortic valve regurgitation was detected in 4 patients (2 men and 2 women, 30 to 65 years old) who had sustained multiple injuries in road accidents 1 week to 30 years before. Three had subadventitial rupture of the ascending aorta and one had isolated rupture of the noncoronary cusp of the aortic valve. The mechanism responsible for the damage was believed to be a consequence of multiple chest lesions (right costal flap, sternal fracture, pulmonary contusion). It is difficult to diagnose and treat aortic regurgitation in patients with multiple injuries. Three patients had repair operations and the remaining patient needed valve replacement. If aortic regurgitation is haemodynamically well tolerated, the operation should be postponed until the patients have recovered from their other injuries. The results in these 4 patients and in other reported cases indicate that operations can be performed soon after the acute phase.
主动脉瓣反流是闭合性胸部损伤的一种罕见后果。它是由瓣膜装置受损（瓣叶破裂）或升主动脉外膜下破裂导致相邻瓣叶脱垂所致。在4例患者（2男2女，年龄30至65岁）中检测到主动脉瓣反流，这些患者在1周前至30年前的道路交通事故中受到多处损伤。3例患者有升主动脉外膜下破裂，1例患者有主动脉瓣无冠瓣孤立破裂。损伤的机制被认为是多处胸部损伤（右侧肋骨皮瓣、胸骨骨折、肺挫伤）的结果。在多处受伤的患者中，主动脉反流难以诊断和治疗。3例患者接受了修复手术，其余患者需要瓣膜置换。如果主动脉反流在血流动力学上耐受性良好，手术应推迟到患者从其他损伤中恢复后进行。这4例患者以及其他报道病例的结果表明，在急性期后不久即可进行手术。
