Eur J Cardiothorac Surg 2007;32:163. doi:10.1016/j.ejcts.2007.03.019
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
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Traumatic right ventricular rupture
Vincent Chana,
Andrew P. Klugb,
Pierre Bedarda,
Ian G. Burwashb,*
a Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
b Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
Received 15 January 2007;
received in revised form 9 March 2007;
accepted 13 March 2007.
* Corresponding author. Address: University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada. Tel.: +1 613 761 5490; fax: +1 613 761 5081. (Email: iburwash{at}ottawaheart.ca).
Key Words: Blunt trauma • Myocardial rupture • Contrast echocardiography • Computed tomography
An 81-year-old man with previous CABG presented to hospital after his car hit a tree. He complained of chest pain, but was hemodynamically stable. Echocardiography with intravenous saline contrast identified right ventricular rupture (Fig. 1
, ), confirmed on computed tomography (Fig. 2
). At surgery, a tear was found in the right ventricle; however, the patient died.
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Fig. 1. Transthoracic echocardiogram demonstrating an echolucent area (arrow) adjacent to the apical right ventricular free wall in the standard apical four-chamber view (top). Prior to contrast injection (middle), a serpiginous echolucent tract (arrow) appears to originate from the right ventricular free wall. Following an intravenous agitated saline contrast injection (bottom), the tract becomes hyperechoic as it fills with agitated saline (dashed line), confirming a right ventricular free wall rupture4 (LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle).
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Fig. 2. Computed tomography of the thorax with contrast demonstrating right ventricular rupture with extravasation of contrast into the anterior mediastinum (arrow).
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Appendix A
Supplementary data
Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.ejcts.2007.03.019.
