Emergent Valve Repair for Severe Traumatic Acute Tricuspid Regurgitation in Polytrauma Patients: A Case Report.

Abstract

Background: Traumatic tricuspid regurgitation resulting from blunt chest trauma is a rare complication, and the surgical options remain unclear Case Presentation: We describe the case of a 19-year-old male who sustained polytrauma in a scooter accident. Concomitant medical findings included massive right hemothorax, splenic burst with active bleeding, hemoperitoneum, L1-L3 spinous apophysis fracture, and 2 rib arches. Despite 6 hours of medical treatment, including high doses of noradrenaline and dobutamine, complete stabilization was not achieved. A transesophageal echocardiogram was performed, which revealed tricuspid valve damage, with one leaflet flaring due to rupture of the papillary muscle (impression of the anterior leaflet). An emergent surgery was performed, and the valve was repaired with excellent outcomes. Additionally, hemodynamic stability was achieved postsurgery, and the repair proved to be effective and durable in the medium term.

Conclusion: Severe traumatic acute tricuspid regurgitation in polytrauma patients can lead to cardiogenic shock and may require emergent correction of the valvopathy, as demonstrated in this case. In instances of traumatic acute tricuspid regurgitation caused by papillary muscle rupture, valve repair is a feasible approach and has shown favorable outcomes at midterm followup. Given the complex medical conditions associated with polytrauma and the typically young age of these patients, particular emphasis was placed on preserving the native valve.