title: Delayed presentation of injury to the sinus of valsalva with aortic regurgitation resulting from penetrating cardiac wounds.
abstract: A 39-year-old man had attempted to commit suicide using a small knife to penetrate the anterior chest wall. An emergency operation was performed successfully to repair the penetrating cardiac injury of the right ventricular outflow tract without using cardiopulmonary bypass. Two years after the operation, he was complained of dyspnea and a continuous murmur was detected. Echocardiography and cardiac catheterization revealed aorto-right ventricular fistula in the sinus of valsalva with aortic regurgitation. In operation, the healed laceration of the right coronary cusp and the fistula between aorta and right ventricle were identified. The fistula was closed using a Dacron patch and the aortic valve was replaced with a mechanical valve. Long-term follow-up of penetrating thoracic injuries is important for detecting underlying intracardiac lesions.
authors.affiliation: Department of cardiovascular surgery, Yamanashi Prefectural Central Hospital, Kofu-city, Yamanashi, Japan.
authors.forename: Narutoshi
authors.initials: N
authors.lastname: Hibino
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Hideki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Harunobu
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Masato
authors.initials: M
authors.lastname: Nakajima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Naito
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000379:methods; D017548:Echocardiography, Transesophageal; D006335:Heart Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011379:Prognosis; D012086:Reoperation; D018570:Risk Assessment; D012850:Sinus of Valsalva / Q000293:injuries* / Q000601:surgery; D013406:Suicide, Attempted; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000601:surgery*; D014950:Wounds, Penetrating / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery