Ussia G P, Rapezzi C, Ferlito M, Piovaccari G, Magnani B
Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Bologna.
Cardiologia. 1996 Nov;41(11):1107-11.
Two cases are reported with nonpenetrating chest trauma and involvement of mitral valve in one case and aortic valve cusps in the other, without aortic rupture. In both patients transesophageal echocardiography allowed us an accurate diagnosis, confirmed by surgical findings. In the patient with involvement of the aortic cusps, the regurgitation developed 3 months after the trauma. In conclusion, cardiac valve injuries are rare but not exceptional following nonpenetrating blunt chest trauma. Transesophageal echocardiography is the imaging technique of choice for these patients. The operator performing the study must be aware of the possible coexistence of different cardiac lesions secondary to blunt chest trauma. In the case of valvular regurgitation the accurate definition of the pathophysiological mechanism is mandatory in order to choose the appropriate surgical strategy. In the case of aortic incompetence of unknown origin, a nonpenetrating chest trauma must be searched out during the clinical interview.
本文报告了2例非穿透性胸部创伤病例,其中1例累及二尖瓣,另1例累及主动脉瓣叶,但均无主动脉破裂。在这2例患者中,经食管超声心动图检查均做出了准确诊断,手术结果也证实了这一诊断。在累及主动脉瓣叶的患者中,创伤后3个月出现了反流。总之,心脏瓣膜损伤在非穿透性钝性胸部创伤后虽罕见但并非不常见。经食管超声心动图是这些患者的首选成像技术。进行该项检查的操作人员必须意识到钝性胸部创伤可能继发不同心脏病变的共存情况。对于瓣膜反流病例,为选择合适的手术策略必须准确界定病理生理机制。对于病因不明的主动脉瓣关闭不全病例,在临床问诊时必须排查非穿透性胸部创伤。