title: Traumatic ventricular septal defect and flail tricuspid valve: successful management by an extracorporeal membrane oxygenator-supported hybrid approach.
abstract: We report the successful management of a critically ill patient with a traumatic ventricular septal defect (VSD) and flail tricuspid valve sustained in a motorcycle accident. Multiple orthopedic injuries prevented emergency cardiac surgery. The patient was stabilized by venous arterial extracorporeal membrane oxygenator support which allowed initial orthopedic repair. Repair of his cardiac injuries was then accomplished using a hybrid approach of percutaneous VSD closure using an Amplatzer post myocardial infarction VSD occluder which was also coil embolized followed by surgical tricuspid valve replacement.
authors.affiliation: Division of Cardiology, University of Rochester Medical Center, Rochester, New York.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Ling
authors.forename: H Todd
authors.initials: HT
authors.lastname: Massey
mesh_terms: D000063:Accidents, Traffic; D006328:Cardiac Catheterization / Q000295:instrumentation; D016638:Critical Illness; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004621:Embolization, Therapeutic; D015199:Extracorporeal Membrane Oxygenation; D006335:Heart Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D055989:Septal Occluder Device; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*
keywords: cardiopulmonary support; embolization; fistula/shunts; trauma; valvular heart disease