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Ventricular Septal Defect after Blunt Trauma in a Case of Preexisting Prosthetic Mitral Valve

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52295#.VI-VHsnQrzE

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.
Cite this paper
Nishith, B. , Chirantan, M. , Sanjula, V. , Harpreet, S. and Deepak, S. (2014) Ventricular Septal Defect after Blunt Trauma in a Case of Preexisting Prosthetic Mitral Valve. World Journal of Cardiovascular Surgery, 4, 227-231. doi: 10.4236/wjcs.2014.412033. 
 
References

[1] Kotrec, M., Jassal, D.S., Zieroth, S., Freed, D.H. and Tam, J.W. (2011) Ventricular Septal Defect as a Result of Direct Trauma from Mechanical Mitral Valve Prosthesis. Canadian Journal of Cardiology, 27, e21-e23.
[2] Cherng, W.-J., Bullard, M.J., Chang, H.-J. and Lin, F.-C. (1995) Diagnosis of Coronary Artery Dissection Following Blunt Chest Trauma by Transesophageal Echocardiography. The Journal of Trauma and Acute Care Surgery, 39, 772- 774.
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[3] évora, P.R., Ribeiro, P.J., Brasil, J.C., Otaviano, A.G., Amaral, F.T., Reis, C.L., et al. (1985) Late Surgical Repair of Ventricular Septal Defect Due to Nonpenetrating Chest Trauma: Review and Report of Two Contrasting Cases. The Journal of Trauma and Acute Care Surgery, 25, 1007-1009.
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[5] Moront, M., Lefrak, E.A. and Akl, B.F. (1991) Traumatic Rupture of the Interventricular Septum and Tricuspid Valve: Case Report. The Journal of Trauma and Acute Care Surgery, 31, 134-136.
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[6] End, A., Rödler, S., Oturanlar, D., Müller, M., Jaskulka, R., Grabenwöger, F., et al. (1992) Surgery of Blunt Heart Trauma. Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen, 63, 641.
[7] Schaffer, R.B., Berdat, P.A., Seiler, C. and Carrel, T.P. (1999) Isolated Fracture of the Ventricular Septum after Blunt Chest Trauma. The Annals of Thoracic Surgery, 67, 843-844.
http://dx.doi.org/10.1016/S0003-4975(99)00044-2               eww141216lx
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