Repair of traumatic ventricular septal defect and associated tricuspid insufficiency : a case report

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.