Unsuspected Location of a Ventricular Septal Defect after Blunt Chest Trauma

Introduction

Traumatic ventricular septal defect (VSD) is uncommon after blunt chest trauma and is usually the result of high-speed motor vehicle accidents; cardiac injuries occur in 20 % of such accidents [[1]]. Severe cardiac injuries are mostly fatal before the patients arrive at the hospital. A ventricular septal defect following a blunt injury is found in 2 - 10 % of survivors [[2]]. In those who survive, the defect is often unsuspected or overlooked. When ventricular septal injury does occur after blunt trauma, rupture occurs almost exclusively in the muscular portion of the septum, either immediately or after a delay [[3]]. Occasionally, hemodynamically unstable patients require prompt diagnosis and early surgical intervention [[4]].

References

• 1 Glinz W, Turina M. Blunt heart injuries.  Langenbecks Arch Chir. 1986;  369 129-138
• 2 Olsovsky M R, Topaz O, DiSciascio G, Vetrovec G W. Acute traumatic ventricular septal rupture.  Am Heart J. 1996;  131 1039-1041
• 3 Evora P R, Ribeiro P J, Brasil J C. et al . Late surgical repair of ventricular septal defect due to nonpenetrating chest trauma: review and report of two contrasting cases.  J Trauma. 1985;  25 1007-1009
• 4 Clark T A, Corcoran F H, Baker W P, Milis M. Early repair of traumatic ventricular septal defect.  J Thorac Cardiovasc Surg. 1974;  67 121-124
• 5 Parmley L F, Manion W C, Mattingly T W. Nonpenetrating traumatic injury of the heart.  Circul. 1958;  18 371-396
• 6 Pierli C, Iadanza A, Del Pasqua A, Sinicropi G. Unusual localisation of a ventricular septal defect following blunt chest trauma.  Heart. 2001;  86 E6
• 7 Stinson E B, Rowles D F, Shumway N E. Repair of right ventricular aneurysm and ventricular septal defect caused by nonpenetrating cardiac trauma.  Surgery. 1968;  64 1022-1026
• 8 David P R, François G, Arnaud D, Christian R. Transcatheter closure of traumatic ventricular septal defect.  Chest. 2003;  123 2144-2145