초록접수 현황
| 16F-111 | 포스터 발표 |
Rupture of Anterolateral Papillary Muscle after Blunt Chest Trauma
Lee Ji Ha, Joo Sun Jin, Min Ho-Ki², Lee Hyung Chae¹
¹Department of Thoracic and Cardiovascular Surgery, Dongkang Medical Center, Ulsan, Korea, ²Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan Korea
Background : Mitral valve injury after blunt chest trauma is a rare occurrence. Herein, we report a successful surgical case with severe traumatic mitral regurgitation secondary to anterolateral papillary muscle (PM) rupture.
Methods : A 43-year-old man was admitted at emergency room after a traffic accident. Mechanical-assisted ventilation was started because of desaturation. Initial work-up revealed multiple rub fracture, flail chest and lung contusion. 1 day after addmition, hazziness of chest X-ray was aggrevated and O2 saturation was worse to around mid-80s%. To stabilize a patient, V-V ECMO was started. Diagnosis of acute mitral regurgitation due to anterolateral papillary muscle rutured was confirmed by transesophageal echocardiography. He underwent emergency cardiac surgery. Standard cardiopulmonary bypass with bicaval cannulation was instituted. Mitral valve was exposed and examied through A trans-septal approach because the small sized left atrium would be expected. after valve examination, a complete detachment of the trunk of anterolateral PM (Fig. 1). The unrepairable anterior mitral leaflet and papillary muscle were resected, and a mechanical valve was implanted.
Results : Weaning from cardiopulmonary bypass was uneventful. venovenous ECMO and ventilator were weaned off on the 3rd and 15th post operative day respectively. He had an uneventful recovery and was
discharged on 28th postoperative day.
Conclusion : Clinical findings of patients with traumatic mitral injury vary from acute cardiogenic shock to whom that remain asymptomatic for years. Patients presenting with severe blunt chest trauma should undergo cardiac examination to exclude injuries to cardiac structure.
Methods : A 43-year-old man was admitted at emergency room after a traffic accident. Mechanical-assisted ventilation was started because of desaturation. Initial work-up revealed multiple rub fracture, flail chest and lung contusion. 1 day after addmition, hazziness of chest X-ray was aggrevated and O2 saturation was worse to around mid-80s%. To stabilize a patient, V-V ECMO was started. Diagnosis of acute mitral regurgitation due to anterolateral papillary muscle rutured was confirmed by transesophageal echocardiography. He underwent emergency cardiac surgery. Standard cardiopulmonary bypass with bicaval cannulation was instituted. Mitral valve was exposed and examied through A trans-septal approach because the small sized left atrium would be expected. after valve examination, a complete detachment of the trunk of anterolateral PM (Fig. 1). The unrepairable anterior mitral leaflet and papillary muscle were resected, and a mechanical valve was implanted.
Results : Weaning from cardiopulmonary bypass was uneventful. venovenous ECMO and ventilator were weaned off on the 3rd and 15th post operative day respectively. He had an uneventful recovery and was
discharged on 28th postoperative day.
Conclusion : Clinical findings of patients with traumatic mitral injury vary from acute cardiogenic shock to whom that remain asymptomatic for years. Patients presenting with severe blunt chest trauma should undergo cardiac examination to exclude injuries to cardiac structure.
책임저자: Lee Hyung Chae
Department of Thoracic and Cardiovascular Surgery, Dongkang Medical Center, Ulsan, Korea
발표자: Lee Hyung Chae, E-mail : cvsdoc@gmail.com