Travma sonrasý geliþen triküspit kapak hasarý ve önemli triküspit kapak yetersizliði

Altmýþ altý yaþýnda erkek hasta araç içi trafik kazasý sonrasý hastanemize getirildi. Travmaya baðlý subaraknoid kanama, çoklu kosta kýrýðý ve sol hemopnömotoraks mevcuttu. Troponin deðerlerinin yükselmesi (42 ng/ml, referans 0-1 ng/ml) nedeniyle kardiyoloji bölümüne konsülte edilen hastanýn elektrokardiyografisinde iskemi bulgusu yoktu ancak yapýlan transtorasik ekokardiyografide sað boþluklar ile triküspit kapak anulusu geniþlemiþ, triküspit kapak koaptasyonu bozulmuþ olarak izlendi. Triküspit kapak anterior leaflete ait subvalvuler yapýlarda rüptür ve prolapsus mevcuttu; buna baðlý önemli triküspit yetersizliði prolapsusa eþlik ediyordu. Sað ventriküler yetersizlik bulgularý bulunmayan hasta travmaya ait diðer tedavilerin tamamlanmasýnýn ardýndan cerrahi kliniðine gönderildi.

Posttraumatic tricuspid valve injury and severe tricuspid valve regurgitation

A 66-year-old male was brought to our hospital following a car accident. He had subarachnoid hemorrhage, multiple rib fractures, and left hemopneumothorax. He was referred to the Cardiology Department for elevated troponin levels (42 ng/ml, reference 0-1 ng/ml). The electrocardiogram was free of ischemia, whereas the transthoracic echocardiography revealed dilated right heart chambers, enlarged tricuspid annulus and coaptation failure of the tricuspid valvular leaflets. There was rupture on the subvalvular apparatus of the anterior leaflet of the tricuspid valve with accompanying prolapse, causing severe tricuspid valvular regurgitation. The patient did not present right ventricular failure signs and symptoms; he was referred to surgery after the resolution of associated thoracic and cranial injuries.