Penetration cardiac wound associated with anterior mitral leaflet perforation: a case report and review of the literature

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Abstract

The paper presents a  rare case of successful correction of an anterior mitral leaflet perforation. A 28-years old patient was referred with progressive heart failure symptoms at 18  weeks after he had a penetrating stab wound of the right ventricle. Massive pericardial effusion with cardiac tamponade risk and severe mitral valve insufficiency were found at examination. By the time of referral, spontaneous closure of the ventricular septal defect, which is an inevitable component of the “unhappy triad”, had happened. Accurate topical ultrasound diagnosis of the intracardial lesion that resulted from the penetrating wound of the left ventricular outflow allowed for a successful urgent mitral valve reconstruction with a xenopericardial patch and the insertion of a  28  mm MedEng annuloplasty band. To prevent any future pericardial constriction, subtotal pericardectomy by Cooley was performed.

Conclusion: Perioperative echocardiography and subsequent follow up by cardiologist are obligatory in all cases of precordial wounds after discharge from hospital. Timely surgery for traumatic mitral leaflet perforation allows for a successful valvuloplasty.

About the authors

D. A. Basarab

St. Ioasaph's Belgorod Regional Clinical Hospital

Author for correspondence.
Email: basarab.74@yandex.ru
ORCID iD: 0000-0002-6105-864X

Dmitriy A. Basarab – MD, PhD, Cardiovascular Surgeon, Cardiovascular Department, Chief Cardiovascular Surgeon of the Healthcare Department of the Belgorod Region.

8/9 Nekrasova ul., Belgorod, Belgorod Region, 308009, Tel.: +7 (910) 226 16 76

Россия

E. D. Ustyuzhin

St. Ioasaph's Belgorod Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0001-7585-9344

Egor D. Ustyuzhin – MD, Cardiovascular Surgeon, Cardiovascular Department.

8/9 Nekrasova ul., Belgorod, Belgorod Region, 308009 

Россия

D. N. Perutskiy

St. Ioasaph's Belgorod Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-1678-1492

Dmitriy N. Perutskiy – MD, PhD, Specialist of Ultrasound Diagnostics, Department of Functional Diagnostics.

8/9 Nekrasova ul., Belgorod, Belgorod Region, 308009

Россия

A. I. Basarab

St. Ioasaph's Belgorod Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0001-7292-0381

Anna I. Basarab – MD, Cardiologist, Department of Urgent Сardiology with Intensive Care Unite.

8/9 Nekrasova ul., Belgorod, Belgorod Region, 308009

Россия

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