Abstract
A 25-year-old male presented after a motor vehicle accident with tricuspid valve (TV) regurgitation, due to a flail TV secondary to papillary muscle rupture. We highlight the importance of three-dimensional echocardiographic imaging of the tricuspid valve and its utility in aiding a successful surgical repair.
Highlights
The majority of injuries to the tricuspid valve (TV) apparatus are related to blunt chest trauma [1]
On 3D colour flow, the TR was severe, with the jet filling greater than 50% of the right atrium (Figure 4(b))
Our case brings attention to the following pertinent aspects related to traumatic tricuspid valve insufficiency: (1) underreporting of TV injury in Africa and the importance of meticulous screening for TV injury in patients with history of blunt chest trauma; (2) the value of three-dimensional imaging of the TV prior to surgical referral; and (3) early referral for surgery of patients with severe TR due to TV injury
Summary
The majority of injuries to the tricuspid valve (TV) apparatus are related to blunt chest trauma [1]. Motor vehicle accidents (MVA) are a common cause of blunt trauma to the heart. It is unusual for the TV to be involved in isolation [2,3,4]. The aortic valve is most commonly involved, followed by the mitral valve and the TV. The postulated mechanism of injury to the TV in these cases tends to be a rapid deceleration force combined with an increase in intracardiac right chamber pressures [5]. In a vast number of cases of MVA, cardiac injury tends to be overlooked due to other overt injuries [6]. Some authors have advocated routine and timeous use of echocardiography in patients sustaining blunt trauma to the chest [6]. The advent of newer echocardiographic techniques such as threedimensional (3D) imaging acts as a supplementary tool in characterising the precise location of injury to the TV [8]
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