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Late presentation of traumatic tricuspid valve regurgitation after motor vehicle accident managemed with valve replacement surgery: Role of 3D echocardiography

Car accidents induced blunt chest trauma can causemany cardiac complications such as right ventricular free-wall rupture, tricuspid valve rupture, tricuspid valve regurgitation, ventricular septal rupture, coronary artery dissection or thrombosis, left ventricular chordae and papillary muscle rupture, heart failure, and arrhythmias.1–3 One of the most common valvular complication is tricuspid regurgitation (TR),4 which can be diagnosed by transthoracic echocardiography (TTE) acutely and followed by TTE for sequelae.5 Unlike rupture of cardiac wall or left sided valves, tricuspid valve rupture usually does not result in immediate hemodynamic instability and may go undiagnosed.5,6 TR after chest-wall trauma may involve any part of valvular apparatus5,7 anddepending upon the severity of the structural damage to the tricuspid apparatus, themanifestations can vary. Herein we present the case of a car driver who sustained blunt chest-wall trauma and then developed TR due to tricuspid valve leaflet perforation and subsequently another TR jet from tricuspid annular dilation due to right ventriclular and atrial remodeling during long-term follow up.