Tricuspid Chordal Rupture Following Stab Injury: A Case Report.

Introduction Traumatic tricuspid regurgitation is a rare clinical scenario occurring, in most cases, in the setting of blunt chest trauma. Tricuspid insufficiency following penetrating chest trauma remains even more unusual, with only a handful of cases reported. We report a case of a 32-year-old male patient who sustained an isolated stab injury to the left chest wall. He was initially treated with emergency surgery for rupture of the right ventricular free wall. Intraoperative transesophageal echocardiography following correction showed no remaining mechanical complications. The patient had an uneventful postoperative course and was asymptomatic when he was discharged home at the 5th postoperative day. However, in follow-up appointments, the patient complained of exercise intolerance and dyspnea on effort. Transthoracic echocardiography was performed, demonstrating severe tricuspid regurgitation due to flail of the anterior leaflet, as well as dilation of the right heart chambers. The patient was submitted to cardiac reintervention and tricuspid chordal rupture was confirmed. To our knowledge, this is the first reported case of tricuspid chordal rupture following stab injury with successful surgical repair. The case highlights the potential valvular complications of penetrating injuries to the heart and the possibility of late complications following chest trauma.