Aortic valve insufficiency due to rupture of the cusp in a patient with multiple trauma

• Published in: Der Unfallchirurg Vol. 106; no. 6; p. 514
• Main Authors: Vidmar, J, Brilej, D, Voga, G, Kovacic, N, Smrkolj, V
• Format: Journal Article
• Language: German
• Published: Germany 01-06-2003
• Subjects: Accidents, Traffic; Adult; Aortic Valve - injuries; Aortic Valve - surgery; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - surgery; Clavicle - diagnostic imaging; Clavicle - injuries; Echocardiography; Humans; Male; Multiple Trauma; Radiography, Thoracic; Rib Fractures - complications; Rib Fractures - diagnostic imaging; Rupture; Time Factors; Treatment Outcome
• ISSN: 0177-5537
• DOI: 10.1007/s00113-003-0584-y

Lesions of the heart valve caused by blunt chest trauma is rare, but when it does occur it can significantly injure the patient. On the basis of autopsy studies, research shows that heart valves are injured in less than 5% of patients who have died due to impact thoracic trauma. Among the heart valves, the aortic valve is the most often lacerated, which has been proved by relevant autopsy and clinical studies. Aortic valve lesions can be the only injury, but it is possible that additional heart or large vessel injuries are also present (myocardial contusion, rupture of the atrial septum, aortic rupture, rupture of the left common carotid artery). The force that causes such an injury is often great and often causes injuries to other organs and organ systems. In a multiple trauma patient, it is very important to specifically look for heart-related injuries because it is possible that they may be overlooked or missed by the surgeon, because of other obvious injuries. We describe the case of a 41-year-old man with multiple trauma who was diagnosed with aortic valve insufficiency due to rupture of the left coronary cusp 6 weeks after a road accident. Valvuloplasty was performed. Seven years later the patient is free of symptoms and is in good physical condition. Echocardiography showed normal dimensions of the heart chambers, a normal thickness of the heart walls, and normal systolic and diastolic function of the left ventricle. Heart valves are morphologically normal, and only an unimportant aortic insufficiency was noticed by echocardiography.