Heart, lung & circulation
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Heart, lung & circulation · Apr 2011
Case ReportsAcute repair of traumatic tricuspid valve regurgitation aided by three-dimensional echocardiography.
A 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. ⋯ 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.
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Heart, lung & circulation · Apr 2011
Case ReportsAdjuvant therapy with methylene blue in the treatment of right ventricular failure after pulmonary embolectomy.
Severe pulmonary embolism often leads to right ventricular failure after surgical embolectomy secondary to ischaemia reperfusion injury and acute lung injury (ALI). Acute right ventricular dysfunction is traditionally treated with inotropes and vasopressors to maintain cardiac output and coronary perfusion as well as selective pulmonary vasodilators to provide right ventricular afterload reduction. We report the first case of utilisation of methylene (MB) in a patient with acute right ventricular failure and vasoplegic shock after surgical pulmonary embolectomy.