초록접수 현황
| 19F-074 | 포스터 발표 |
Minimally Invasive Approach using the Double Orifice Technique for Traumatic Tricuspid Regurgitation
Chan Kyu Lee¹, Jae Hoon Jang², Nahyeon Lee³, Seunghwan Song³
¹Department of Trauma Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital Trauma Center, Busan, Republic of Korea, ²Department of Orthopedic Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital Trauma Center, Busan, Republic of Korea, ³Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital Trauma Center, Busan, Republic of Korea
Purpose : Traumatic tricuspid insufficiency is a rare disease and we report good results by minimally invasive surgery.
Results : A 37-year-old man who was involved in a road traffic accident was transferred to our level I trauma center. He was diagnosed locally with Rt. transverse-posterior wall acetabular fracture, multiple rib fractures, and liver contusion. We discovered severe tricuspid regurgitation during work-up for acetabular surgery. After consultation with the cardiologist and anesthesiologist, we decided to cautiously perform orthopaedic surgery, but the patient sustained near cardiac arrest perioperatively while changing position from supine to lateral decubitus. It was decided that tricuspid valve repair should precede orthopaedic surgery. Minimally invasive approach for tricuspid valve repair using the double orifice technique was performed on post-trauma day 10. As postoperative echocardiography showed minimal TR, acetabular surgery was performed 5 days later. He recovered well and was discharged the day after surgery without any complications.
Conclusion : Most traumatic tricuspid insufficiency is asymptomatic and bleeding from concomitant injuries makes it difficult to determine surgery early. However, if the bleeding is measured through a series of procedures and low concentrations of heparin are used during the surgery, it is thought that the operation can be performed without any problem. In addition, minimally invasive surgery may be an alternative because it has the advantage of securing the vision due to posture.
Results : A 37-year-old man who was involved in a road traffic accident was transferred to our level I trauma center. He was diagnosed locally with Rt. transverse-posterior wall acetabular fracture, multiple rib fractures, and liver contusion. We discovered severe tricuspid regurgitation during work-up for acetabular surgery. After consultation with the cardiologist and anesthesiologist, we decided to cautiously perform orthopaedic surgery, but the patient sustained near cardiac arrest perioperatively while changing position from supine to lateral decubitus. It was decided that tricuspid valve repair should precede orthopaedic surgery. Minimally invasive approach for tricuspid valve repair using the double orifice technique was performed on post-trauma day 10. As postoperative echocardiography showed minimal TR, acetabular surgery was performed 5 days later. He recovered well and was discharged the day after surgery without any complications.
Conclusion : Most traumatic tricuspid insufficiency is asymptomatic and bleeding from concomitant injuries makes it difficult to determine surgery early. However, if the bleeding is measured through a series of procedures and low concentrations of heparin are used during the surgery, it is thought that the operation can be performed without any problem. In addition, minimally invasive surgery may be an alternative because it has the advantage of securing the vision due to posture.
책임저자: Chan Kyu Lee
Department of Trauma Surgery, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital Trauma Center, Busan, Republic of Korea
발표자: Chan Kyu Lee, E-mail : apolo1980@hanmail.net