Device closure of a traumatic VSD in a young man with a history of a stab wound to the chest

Abstract

The most commonly affected area of the heart in penetrating chest trauma is the right ventricle. The occurrence of a ventricular septal defect (VSD) after penetrating trauma to the left chest has an incidence of 1% to 5%. We describe a 27-year-old man with a history of the surgical repair of right ventricular free-wall rupture due to a stab wound to the chest and a posterior muscular VSD, which was diagnosed with transthoracic echocardiography postoperatively. We closed the VSD with a symmetric occluder successfully. <Learning objective: Cardiac penetrating trauma is not always limited to the right ventricular free wall and may involve the cardiac valves, the heart septa, the coronary arteries, and the conduction system. Traumatic ventricular septal defect (VSDs) can be treated surgically or percutaneously with occluder devices. It appears that the device closure of this type of acquired VSD is a reasonable therapeutic choice, especially in patients with a history of recent cardiac surgery for the repair of right ventricular free wall rupture.>.

Keywords: Cardiac trauma; Heart injury; Transesophageal echocardiography; Ventricular septal defect.

Fig. 1

Chest X-ray showed sternal wires and increased bronchovascular marking of lungs suggestive of left to right shunt.

Fig. 2

Transesophageal echocardiography revealed small to moderate size muscular ventricular septal defect with left to right flow.