[Four operated cases of traumatic tricuspid regurgitation]

Four cases of tricuspid regurgitation due to nonpenetrating chest trauma are presented. From five to twenty five years after the initial blunt chest trauma, they were admitted because of dyspnea or palpitation on exertion. In all cases echocardiogram showed severe tricuspid regurgitation and enlarged right atrium and ventricle. Cardiac catheterization revealed increased right atrial pressure with high v wave. At operation, their tricuspid valves or chordae tendineae were revealed ruptured without other valvular injury. Ruptured chordae tendineae of the anterior leaflet were in three cases and their valves were replaced with mechanical prosthesis. Tear of the anterior leaflet was in one case and it was sutured directly, but mild tricuspid regurgitation was left after the operation. Twenty cases have been reported in Japan up to date and fifteen of them have surgical treatment; tricuspid valve replacement (TVR) is performed in 10 cases, tricuspid valvuloplasty (TVP) is in 3 cases, suture of ruptured chordae tendineae is in 2 cases. Five cases are treated medically. How to diagnose and how to treat them are discussed. And, in the conclusion, we consider that the surgical treatment is recommended for the case of traumatic tricuspid regurgitation with uncontrollable heart failure.