[Acute post-traumatic aortic insufficiency: transesophageal echocardiography in the diagnosis and therapy of the lesions].
A 58-year-old car driver suffered a road accident responsible for severe blunt thoraco-abdominal trauma. Transoephageal echocardiography, performed following the secondary development of a diastolic murmur, confirmed the presence of aortic incompetence due to commissural avulsion and guided the surgical treatment, which consisted of commissural suspension under cardiopulmonary bypass via a mini transverse trans-sternal incision. The rarity of acute aortic valve incompetence following non-penetrating thoracic trauma is illustrated by the data of the literature. This lesion is due to either avulsion of a sigmoid cusp or commissure, or laceration of the valvular tissue. Transthoracic echocardiography confirms the reality of aortic incompetence suggested clinically by appearance of a diastolic murmur, but confirmation of the mechanism of the lesions is based on transoesophageal echocardiography which allows perfectly safe and rapid visualization of the mechanism of the valvular lesion, investigation of associated lesions and guidance of therapeutic management.
Brandstätt
P
P
Service de Médecine Aéronautique et Pathologie Cardiovasculaire, Hôpital Bichat, C.H Bichat-C. Bernard, Paris.
Carlioz
R
R
Fontaine
B
B
Hémery
Y
Y
Pats
B
B
Chapuis
O
O
Lang-Lazdunsky
L
L
Jancovici
R
R
Burlaton
J P
JP
Hvass
U
U
D000063:Accidents, Traffic; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001334:Automobile Driving; D017548:Echocardiography, Transesophageal / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D014949:Wounds, Nonpenetrating