Abstract
We present a case of an isolated large ventricular septal defect (VSD) following blunt chest trauma in a motor vehicle accident in the patient with preexisting mechanical mitral valve. Transthoracic echocardiography revealed a large muscular VSD with significant left to right shunt along with septal edema. Surgical repair was performed in view of Qp:Qs of 2.5 with significant hemodynamic instability despite intra-aortic balloon pump. The ventricular septal defect was found in apical muscular portion of the interventricular septum, which was closed through left ventriculotomy. We here discuss the possible mechanisms of damage and importance of timely surgery. To conclude, minor looking external injury might contain devastating damage inside, especially with patients on anti-coagulant therapy.
Highlights
Cardiac injuries resulting from blunt chest trauma are usually because of high speed motor vehicle accidents
Blunt chest trauma can cause a variety of cardiac injuries such as myocardial contusion, myocardial rupture, ventricular septal defect (VSD), pericardial trauma, valvar disruption and acute myocardial infarction
There are several case reports of VSD after penetrating and blunt chest trauma but during the literature review we found only one case report [1] of post traumatic VSD in presence of prosthetic mitral valve, signifying its rarity
Summary
Cardiac injuries resulting from blunt chest trauma are usually because of high speed motor vehicle accidents. The severity of external injuries does not necessarily reflect the degree of cardiac trauma. Blunt chest trauma can cause a variety of cardiac injuries such as myocardial contusion, myocardial rupture, ventricular septal defect (VSD), pericardial trauma, valvar disruption and acute myocardial infarction. How to cite this paper: Nishith, B., Chirantan, M., Sanjula, V., Harpreet, S. and Deepak, S.K. (2014) Ventricular Septal Defect after Blunt Trauma in a Case of Preexisting Prosthetic Mitral Valve. World Journal of Cardiovascular Surgery, 4, 227-231. B. Nishith et al traumatic VSD in preexisting prosthetic mechanical mitral valve. Anti-coagulation therapy adversely affected the traumatized heart resulting in extensive septal contusion
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