title: Cardiopulmonary bypass after severe blunt hepatic injury: management of multi-system blunt trauma in an adolescent.
abstract: A 16-year-old adolescent male sustained combined injuries to the tricuspid valve and liver. This injury is exceptional due to the mechanism and the circumstances in which it took place: a flying pumpkin thrown from a sport utility vehicle. An echocardiogram demonstrated a flail chordal apparatus associated with the posterior leaflet of the tricuspid valve, creating substrate for severe tricuspid regurgitation with preserved right heart function. He was treated with non-operative management for the liver injury; he remained hemodynamically stable and was discharged home. He underwent successful repair of the tricuspid valve 17 days following the initial injury necessitating systemic anticoagulation and was discharged home two days later. The patient recovered fully without residual valvular pathology or hepatic sequelae.
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA. streit@musc.edu
authors.forename: Stephanie
authors.initials: S
authors.lastname: Streit
authors.forename: Minoo
authors.initials: M
authors.lastname: Kavarana
authors.forename: Mark A
authors.initials: MA
authors.lastname: Scheurer
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cina
mesh_terms: D000293:Adolescent; D058385:Cardiac Valve Annuloplasty; D002315:Cardiopulmonary Bypass; D006335:Heart Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery*; D014261:Tricuspid Valve / Q000293:injuries / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*
keywords: Blunt cardiac trauma; Liver laceration; Tricuspid valve rupture