• Paul J Conaglen, Andris Ellims, Colin Royse, and Alistair Royse.
• Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Grattan Street, Parkville, Victoria 3050, Australia. paulandsarahconaglen@yahoo.co.nz
• Heart Lung Circ. 2011 Apr 1;20(4):237-40.

AbstractA 54 year-old man without prior cardiac history was involved in a motor vehicle accident. His heart rate was 100/min and blood pressure 128/78 mmHg. He complained of anterior chest pain, and on examination had a loud pan-systolic murmur with no clinical signs of heart failure. Three-dimensional trans-oesophageal echocardiography (3D-TOE) demonstrated partial rupture of the inferior head of the anterior papillary muscle (when 2D-TOE did not), causing severe tricuspid regurgitation. This was successfully repaired. Tricuspid valve insufficiency is a rare, but well documented, complication of blunt chest trauma. The majority of cases of tricuspid regurgitation caused by blunt trauma are diagnosed and treated late after the traumatic event. Acute diagnosis is less common but possible with a high level of vigilance, and is greatly aided by clinical indicators of cardiac injury. We describe a case of acute repair of traumatic tricuspid insufficiency, in which diagnosis and surgical planning were greatly aided by 3D-TOE.Copyright © 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

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