Traumatic aortic insufficiency after blunt chest trauma

Traumatic aortic insufficiency is an uncommon result of blunt trauma. The typical clinical features include trauma, followed by pain (and often syncope), a musical aortic diastolic murmur, and progressive cardiac decompensation. Shock is an unusual manifestation of traumatic aortic insufficiency. In this report, a patient is described who experienced shock, a widened mediastinum, and failure to respond to fluid resuscitation after cardiac injury in an automobile accident. Emergency surgery was performed and an intimal tear was repaired. A #25 Carpentier-Edwards bioprosthesis was used to replace the aortic valve, which was avulsed from the commissure of the right and left cusps. Since aortic valve replacement offers an excellent prognosis, it should be done at the first signs of cardiac decompensation.