Posttraumatic Coronary Artery-Right Ventricular Fistula with Multiple Ventricular Septal Defects

Zamani, Jalal; Amirghofran, Ahmad Ali; Moaref, Alireza; Afifi, Sasan; Rezaian, Gholam Reza

doi:10.1111/j.1540-8191.2010.01032.x

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…This may occur as a result of direct cardiac impact or when the heart is compressed between the sternum and the spine. [3578111520] It has also been suggested that a healed congenital VSD with a weakened ventricular septum may re-open with significant blunt trauma to the chest. [6] Delayed inflammatory rupture is thought to occur when cardiac injury causes localised edema with disruption of microvascular flow, leading to infarction, septal liquefaction, and perforation.…”

Section: Discussionmentioning

confidence: 99%

Ventricular septal defect following blunt chest trauma

Ryan

Skinner²,

Rodseth

2012

J Emerg Trauma Shock

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We present a 32-year-old male with ventricular septal defect (VSD) following blunt chest trauma. Traumatic VSD is a rare but potentially life-threatening injury, the severity, course and presentation of which are variable. While the diagnosis of myocardial injury may be challenging, cardiac troponins are useful as a screening and diagnostic test. The proposed pathophysiological mechanisms in the development of traumatic VSD are early mechanical rupture and delayed inflammatory rupture. We conducted a literature review to investigate the pathogenesis, distribution of patterns of presentation, and the associated prognoses in patients with VSD following blunt chest trauma. We found that traumatic VSDs diagnosed within 48 hours were more likely to be severe, require emergency surgery and were associated with a higher mortality. Children with traumatic VSDs had an increased mortality risk. Smaller lesions may be managed conservatively but should be followed up to detect late complications. In both groups elective repair was associated with a good outcome.

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Section: Discussionmentioning

confidence: 99%

Ventricular septal defect following blunt chest trauma

Ryan

Skinner²,

Rodseth

2012

J Emerg Trauma Shock

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“…Coronary artery rupture or coronary artery fistula from blunt thoracic trauma is very rare, and few cases associated with a traumatic ventricular septal defect have been described [2–4]. This is, to the best of our knowledge, the first reported case of coronary artery fistula (RCA to RA) and occlusion with an inferior MI that occurred following blunt chest trauma worldwide.…”

Section: Discussionmentioning

confidence: 95%

Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma

Kim

Lee

et al. 2014

Korean J Thorac Cardiovasc Surg

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Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications.

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“…Mechanical septal rupture may occur as a result of direct cardiac impact or when the heart is compressed between the sternum and the spine. [ 2 5 7 8 9 ] It has also been suggested that a healed congenital VSD with a weakened ventricular septum may be re-opened with significant blunt trauma to the chest. [ 6 ] Delayed inflammatory rupture is thought to occur when cardiac injury leads to localized edema, disruption of microvascular flow, leading to infarction, septal liquefaction, and perforation.…”

Section: Discussionmentioning

confidence: 99%

“…Presenting signs are often masked by concomitant injuries, and the severity, presentation, and course are variable. [ 1 2 3 4 5 6 7 8 9 10 ] The mainstay of diagnosing VSDs is the transthoracic echocardiogram. This case report describes a rare case of acquired posttraumatic VSD as a complication of nonpenetrating chest trauma that occurred during a motor vehicle collision.…”

Section: Introductionmentioning

confidence: 99%