Unusual localisation of a ventricular septal defect following blunt chest trauma

Pierli, Carlo; Iadanza, Alessandro; Pasqua, Alessia Del; Sinicròpi, Giuseppe

doi:10.1136/heart.86.1.e6

Cited by 16 publications

(24 citation statements)

References 9 publications

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“…[34] Its severity, presentation and course are variable,[35–8] presenting signs are often masked by concomitant injuries,[6] and the presentation of the murmur is often delayed. [2679]…”

Section: Introductionmentioning

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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“…[34] Its severity, presentation and course are variable,[35–8] presenting signs are often masked by concomitant injuries,[6] and the presentation of the murmur is often delayed. [2679]…”

Section: Introductionmentioning

confidence: 99%

Ventricular septal defect following blunt chest trauma

Ryan

Skinner²,

Rodseth

2012

J Emerg Trauma Shock

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“…Though the mechanism underlying post-traumatic VSD remains unclear, it is thought to occur due to the compression of the heart between the sternum and spine during early systole or late diastole when the ventricles are fully filled and the atrioventricular valves are closed. 2 Post-traumatic muscular VSD is variable in its presentation, temporal course, and severity. 4 Surgical closure of post-traumatic muscular VSD is challenging, since post-traumatic VSD is frequently hidden within the coarse right ventricular trabeculations.…”

Section: Discussionmentioning

confidence: 99%

“…Ventricular septal defect (VSD) following blunt chest trauma is unusual . Perventricular closure of a VSD under transesophageal echocardiogram (TEE) guidance is emerging as an alternative to conventional open surgery .…”

mentioning

confidence: 99%

“…Ventricular septal defect (VSD) following blunt chest trauma is unusual. 1,2 Perventricular closure of a VSD under transesophageal echocardiogram (TEE) guidance is emerging as an alternative to conventional open surgery. 3 We report a case of successful perventricular occlusion of a post-traumatic muscular VSD under TEE guidance in a patient sustaining blunt chest trauma in a motor vehicle accident.…”

mentioning

confidence: 99%

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Perventricular Closure of a Post-Traumatic Muscular Ventricular Septal Defect Guided by Transesophageal Echocardiogram

Bao

Wang

et al. 2013

J Card Surg

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Minimally invasive perventricular closure is emerging as an alternative to conventional open surgery in treating traumatic ventricular septal defects (VSDs). We report a case of successful perventricular closure of a post-traumatic muscular VSD in a patient who sustained blunt chest trauma in a motor vehicle accident. A larger Amplatzer muscular VSD occluder (16 mm in diameter) was used to close the VSD near the apex.

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“…Traumatic VSD is thought to occur due to compression of the heart between the sternum and the spine during early systole or late diastole while the ventricles are fully filled and the atrioventricular valves are closed, resulting in excessive intraventricular pressure 1 . The most common location of these VSDs is the muscular septum close to the apex.…”

Section: Discussionmentioning

confidence: 99%