Spontaneous Closure of a Traumatic Ventricular Septal Defect Following a Penetrating Injury

Midell, Allen I.; Replogle, Robert L.; Bermudez, Gustave

doi:10.1016/s0003-4975(10)64227-0

Cited by 18 publications

(10 citation statements)

References 14 publications

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“…2 Although the most common chamber involved in cardiac injuries is the right ventricle, it is clearly due to its anatomical location. [1][2][3][4][5][6] It has been postulated that the reason for the delay of VSP is due to a muscle spasm or a blood clot sealing the defect. 1 Table 1 shows that the time to reach a diagnosis of VSP ranges from 1 day to 10 years.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] It has been postulated that the reason for the delay of VSP is due to a muscle spasm or a blood clot sealing the defect. 1,3 Patients with small VSPs and no evidence of heart failure can be managed conservatively with serial echocardiography, 5 and in some cases, small defects could even close spontaneously over time. 7 Conservative management is advocated in asymptomatic muscular VSPs, where in the absence of pulmonary hypertension, ventricular dimensions remain normal and Qp/Qs remains <2.…”

Section: Discussionmentioning

confidence: 99%

“…1 Diagnosis of ventricular septal perforation (VSP) could be delayed until the patient's clinical status improves. [1][2][3][4][5][6] It is important to repeat an echocardiography; however, computed tomography (CT) is also useful for anatomical detection. 1,4 We present a case of VSP with hematoma formation in the perforation site on an initial contrast CT.…”

Section: Introductionmentioning

confidence: 99%

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Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

Shioya

Inoue

Muto

et al. 2019

Acute Medicine & Surgery

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Background Ventricular septal perforation (VSP) can be caused by a penetrating cardiac injury. Diagnosis of VSP tends to be delayed because a shunt might not be detected by color flow Doppler at an early stage following injury. Case presentation A 60‐year‐old man with depression was admitted to the emergency center after a knife injury in the chest. A focused assessment with sonography for trauma revealed cardiac tamponade. Shortly after an open cardiac massage and a pericardiotomy, his spontaneous circulation returned. At a later stage, follow‐up computed tomography, echocardiography, and left ventriculography showed traumatic ventricular septal perforation. Conservative therapy was chosen because the pulmonary blood flow/systemic blood flow ratio was 1.42. Conclusion The initial contrast computed tomography shows a septal hematoma. Its presence could be perceived as a perforation site in the interventricular septum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

Shioya

Inoue

Muto

et al. 2019

Acute Medicine & Surgery

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“…7 The timing of closure remains a subject of debate and while spontaneous closure of traumatic VSDs has been reported on several occasions, patients are often symptomatic necessitating closure. 8,9 Because of extensive experience in adult congenital disease, surgical repair has been the benchmark for treating acquired VSDs. 10 More recently, transcatheter techniques have been introduced as a lessinvasive alternative.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of a traumatic ventricular septum defect resulting from a stab wound

Dedic

Nieman

Bogers

et al. 2013

European Heart Journal: Acute Cardiovascular Care

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A 25-year-old man with a ventricular septal defect resulting from a stab wound to his chest was admitted to our hospital. Because of extensive comorbidity and favourable location, transcatheter closure with an Amplatzer device was preferred over surgical repair. Ventricular septal defects are an uncommon complication of cardiac trauma, but when they do occur from this cause, they often have more dramatic consequences. Transcatheter closure is an attractive, less-invasive alternative in patients with increased surgical risk, multiple previous surgical interventions, or poorly accessible defects.

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“…Complex hemodynamic or combined lesions of the traumatic insults are often overlooked initially, or deemed trival, and hence, the timing and operative indications for these secondary repairs are controversial. [5][6][7][8][9] Posttraumatic ventricular septal defects have not required routine closure because survivors more often have small defects and usually progress with spontaneous closures These usually young patients have great tolerance of small shunts from these penetrating injuries (ie, less than 2:1 1 shunt). 1-4 These were the reasons for our relative hesitation for immediate operative repair.…”

Section: Case Reportmentioning

confidence: 99%

Repair of Traumatic Ventricular Septal Defect and Associated Tricuspid Insufficiency: A Case Report

Yee

1992

Vascular Surgery

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Penetrating cardiac trauma often results in serious and life-threatening sequelae. Traumatic ventricular septal defect and valvular insufficiency are among the rarest. The author presents a case of a young man who sustained cardiac arrest from ventricular tamponade secondary to a penetrating left ventricular stab wound. This patient was successfully resuscitated after open manual massage. A significant ventricular septal defect and associated tricuspid regurgitation were detected on the following day. Serial echocardiograms were used to evaluate the evolution of these two hemodynamic defects. The patient underwent operative repair for patch closure of a defect the size of a quarter and repair of the associated tricuspid papillary muscle dysfunction. His pulmonary status and right ventricular failure improved with resolution of his ascites. The operative and medical considerations are discussed for these unique traumatic intracardiac defects.

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Spontaneous Closure of a Traumatic Ventricular Septal Defect Following a Penetrating Injury

Cited by 18 publications

References 14 publications

Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

Transcatheter closure of a traumatic ventricular septum defect resulting from a stab wound

Repair of Traumatic Ventricular Septal Defect and Associated Tricuspid Insufficiency: A Case Report

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