title: Complex Surgical Repair of a Flail Tricuspid Valve After Chest Wall Trauma in a Pediatric Patient.
abstract: Traumatic injury to the tricuspid valve can result from severe nonpenetrating chest wall trauma. We present the case of an initially asymptomatic 11-year-old girl who was kicked in the chest by a horse. The trauma resulted in avulsed papillary muscles, ruptured chordae, and right heart failure. She underwent early tricuspid valve reconstruction and annuloplasty. We advocate for routine use of echocardiography to assess for traumatic injury to intracardiac structures. In addition, we believe that early surgical intervention may prevent right-sided heart dysfunction, atrial arrhythmias, and the need for valve replacement.
authors.affiliation: Department of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas. Electronic address: robert.loar@bcm.edu.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Loar
authors.affiliation: Department of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Shiraz A
authors.initials: SA
authors.lastname: Maskatia
authors.affiliation: Department of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Ericka Scheller
authors.initials: ES
authors.lastname: McLaughlin
authors.affiliation: Department of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Antonio R
authors.initials: AR
authors.lastname: Mott
authors.affiliation: Department of Congenital Heart Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Iki
authors.initials: I
authors.lastname: Adachi
authors.affiliation: Department of Congenital Heart Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Fraser
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging; D035441:Thoracic Wall / Q000293:injuries*; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging