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Post-traumatic mitral regurgitation and ventricular septal defect in absence of left pericardium
Insights
A six-year-old boy with congenital absence of the pericardium experienced traumatic cardiac injuries, including mitral regurgitation and ventricular septal defect. Surgical repair was complicated by a residual shunt, requiring a second operation.
Area of Science:
- Cardiology
- Congenital Heart Defects
- Traumatic Cardiac Injury
Background:
- A six-year-old boy sustained severe cardiac trauma from a car accident.
- Initial assessment revealed acute post-traumatic mitral regurgitation (MR) and ventricular septal defect (VSD).
Observation:
- During surgery for mitral valve replacement and VSD closure, congenital absence of the left pericardium was noted.
- Postoperative cardiac catheterization identified a residual left-to-right shunt at the ventricular level.
Findings:
- The patient required a second surgery 10 months post-initial operation to close the residual VSD.
- Six months after the second surgery, the patient's condition is good.
Implications:
- Congenital absence of the pericardium may predispose individuals to traumatic cardiac lesions.
- This condition might also contribute to postoperative pulmonary complications, particularly on the left side.
Abstract:
A six-year-old boy was hospitalized following a car accident. Cardiac catheterization demonstrated acute post-traumatic mitral regurgitation (MR) and ventricular septal defect (VSD). The patient was operated on for mitral valve replacement and closure of the VSD. On opening the chest absence of the left pericardium was noted. Cardiac catheterization performed in the postoperative period demonstrated a residual left-to-right shunt at ventricular level. The patient was reoperated on 10 months later for closure of the residual VSD. Six months after the last operation the patient is in good condition. The congenital absence of the pericardium is considered as favoring both the post-traumatic cardiac lesions and the postoperative pulmonary problems on the left side.