[MEP-45] Traumatic Blowout Injury-Related Gerbode Defect and Aortic Dissection

Area of Science:

• Cardiology
• Trauma Surgery

Background:

• The Gerbode defect, an abnormal connection between the left ventricle and right atrium, can be congenital or acquired, often due to trauma.
• Acquired heart conditions like Gerbode defects, sinus of Valsalva injuries, and tricuspid valve damage are frequently linked to mechanical trauma, including vehicle accidents.

Purpose of the Study:

• To report the first documented case of combined ventricular septal defect (VSD), aortic dissection, Gerbode defect, and severe tricuspid valve damage resulting from a truck tire explosion.
• To describe the transcatheter and surgical management of these complex traumatic cardiac injuries.

Main Methods:

• A 13-year-old male patient presenting with severe chest pain post-truck tire explosion underwent comprehensive echocardiographic evaluation.
• Diagnostic imaging revealed right atrium enlargement, perimembranous VSD, an 8-mm Gerbode defect, and tricuspid valve leaflet defects causing severe insufficiency.
• Surgical intervention involved VSD closure using two separate patches to address both the Gerbode-type and perimembranous defects.

Main Results:

• The patient presented with multiple cardiac injuries including VSD, aortic dissection, a Gerbode defect, and severe tricuspid insufficiency following a high-pressure truck tire explosion.
• Echocardiography confirmed a significant left ventricle-to-right atrium shunt due to the Gerbode defect and damage to the tricuspid valve septal leaflet.
• Surgical VSD closure was successfully performed using two patches, with no residual tricuspid valve defects noted post-repair.

Conclusions:

• Severe cardiac trauma, including complex septal defects and valve damage, can result from extreme pressure events like industrial explosions.
• Prompt diagnosis and surgical management are crucial for addressing life-threatening traumatic cardiac injuries.
• This case highlights the potential for catastrophic cardiac damage from seemingly unusual traumatic mechanisms.