title: A successful treatment for concomitant injury of the coronary artery and tricuspid valve after blunt chest trauma.
abstract: A 63-year-old woman involved in an automobile accident was brought to our hospital with thoracic injury sustained by the impact of her vehicle's steering wheel. Cardiac auscultation revealed a grade III/VI systolic murmur and the electrocardiogram showed ST elevation in leads 2, 3 and aVF. A 2D echocardiogram revealed severe tricuspid regurgitation and a hypokinetic right ventricle. Coronary angiography revealed dissection of the proximal right coronary artery (RCA) with 90 % stenosis. Urgent CABG for the RCA and tricuspid valvuloplasty were performed, as the anterior leaflet of the tricuspid valve had prolapsed as a result of chordal rupture. Blunt thoracic trauma causing both tricuspid insufficiency and coronary artery dissection is a very rare and life-threatening situation. Prompt diagnosis and timely surgery enabled us to save this patient's life.
authors.affiliation: Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan. chizuo@kk.email.ne.jp.
authors.forename: Chizuo
authors.initials: C
authors.lastname: Kikuchi
authors.affiliation: Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Motohashi
authors.affiliation: Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakazawa
authors.affiliation: Department of Cardiovascular Surgery Stroke and Cardiovascular Center, Niigata City General Hospital, 463-7 Shumoku Chuo-ku, Niigata city, 951-1197, Niigata, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanazawa
mesh_terms: D000063:Accidents, Traffic; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000293:injuries; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D013898:Thoracic Injuries / Q000150:complications / Q000601:surgery*; D014261:Tricuspid Valve / Q000293:injuries* / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000601:surgery*
keywords: Cardiac injury; Coronary artery dissection; Thoracic trauma; Tricuspid insufficiency
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