• Kimberly D Ngo, Phillip Pian, Robert Hanfland, Christopher S Nichols, Glenn R Merritt, David Campbell, and Richard J Ing.
• From the *Department of Anesthesiology, †Department of Cardiothoracic Surgery, Children's Hospital Colorado, University of Colorado Hospital, Aurora, CO.
• Pediatr Emerg Care. 2016 Jul 1; 32 (7): 468-71.

AbstractAll-terrain vehicle (ATV) accidents leading to severe morbidity and mortality are common. At our institution, 2 children presented within weeks of each other after ATV accidents. Both children required cardiac valve surgery. The surgical management of these 2 children is discussed, and the literature is reviewed. On initial patient presentation, the diagnosis of a ruptured cardiac valve or ventricular septal defect (VSD) associated with these types of accidents is often delayed. We propose that patients presenting with evidence of high-energy blunt thoracic trauma after an ATV accident should undergo an electrocardiogram, cardiac enzyme assessment, and cardiac echocardiogram as part of the initial work-up to rule out significant myocardial injury.

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