Citation

Marques CA, Mil-Homens F, Resende CX, Fernandes J, Gouveia D, Pinho P, Macedo F. Rev. Port. Cardiol. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Sociedade Portuguesa de Cardiologia, Publisher Elsevier Publishing)

DOI

10.1016/j.repc.2023.05.010

PMID

37481239

Abstract

A 22-year-old male was admitted to the emergency room due to left hemithorax injury from a screwdriver (Figure 1A). The patient was hemodynamically stable, with a slightly altered mental status. Chest computed tomography was performed and revealed moderate pericardial effusion, leading to an evaluation by the cardiology emergency team. The transthoracic echocardiogram revealed severe aortic valve regurgitation, raising suspicion about aortic root injury, as well as fistulous communications between heart chambers (Figure 1B-D). These findings led to emergent surgery.

Intraoperative transesophageal echocardiogram images confirmed an injury path originating in the right ventricle, crossing the aortic valve root, and ending in the left atrium (Figure 2 A-C). An aortic valve replacement, closure of the aortic root fistulas and infundibular lesion were performed (Figure 2D). The patient had excellent postoperative recovery and was discharged after six days....

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