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Post-traumatic ventricular septal defect following coronary bypass surgery
U Bortolotti1, A Milano, G Scioti
1Department of Cardiac Surgery, University of Pisa Medical School, Italy.
Insights
A rare case of ventricular septal defect occurred after chest trauma in a patient who previously had coronary artery bypass grafting. Surgical closure of the defect was successful, highlighting a unique clinical scenario.
Area of Science:
- Cardiology
- Cardiac Surgery
- Trauma Surgery
Background:
- A 60-year-old male with a history of myocardial infarction and coronary artery bypass grafting (CABG) presented with trauma.
- The patient sustained significant abdominal and thoracic trauma from a motor vehicle accident.
Observation:
- Four years post-CABG, the patient experienced blunt chest trauma.
- A ventricular septal defect (VSD) was diagnosed approximately one month after hospital discharge.
- Coronary angiography confirmed the patency of all bypass grafts.
Findings:
- Two-dimensional Doppler echocardiography identified the VSD.
- Successful surgical closure of the VSD was achieved using a right atrial approach.
- This represents a previously unreported instance of VSD following blunt chest trauma in a post-CABG patient.
Implications:
- This case highlights a rare complication of VSD secondary to blunt thoracic trauma in patients with prior cardiac revascularization.
- It underscores the importance of considering traumatic VSD in patients with relevant injury history, even post-CABG.
- The successful surgical management demonstrates the feasibility of VSD closure in complex cardiac patients.
Abstract:
A 60-year-old patient underwent triple coronary artery bypass grafting following an inferoseptal myocardial infarction and early onset of exertional angina. Four years later he was involved in a car accident during which he sustained an abdominal and thoracic trauma. Approximately 1 month after discharge, a ventricular septal defect was diagnosed by two-dimensional Doppler echocardiography with patency of all grafts at coronary angiography. Closure of the septal defect was successfully accomplished through a right atrial approach. Rupture of the ventricular septum following blunt chest trauma in a patient with previous myocardial revascularization has not been previously reported.