Traumatic Tricuspid Regurgitation Complicated with Severe Liver Dysfunction

Takashi Kajiwara	Masahiro Oe	Satoshi Fujita
Hideki Tatewaki and Koji Fukae

（Department of Cardiovascular Surgery, Kumamoto City Hospital, Kumamoto, Japan）

A 67-year-old man was admitted with heart failure. He had a past history of closed chest trauma due to a traffic accident at the age of 24. He had been complaining of a gradual increase of fatigue since a few years after the accident and received medical treatment. At approximately 40 years of age, he underwent cardiac catheterization and was given a diagnosis of Ebstein malformation. However surgery was not recommended. An echocardiogram showed a laceration at the tricuspid valve, enlargement of the tricuspid valve annulus and severe tricuspid regurgitation. The displacement of tricuspid valve was not present. His case was complicated with severe liver dysfunction of Child-Pugh class B and Model for End-Stage Liver Disease score 15. We performed tricuspid valve replacement with a Mosaic 31mm tissue valve. The patient required pleurodesis for refractory severe pleural effusion at 2-months and was discharged 6 months after the operation.

　

Jpn. J. Cardiovasc. Surg. 43:76-79（2014）

Keywords：traumatic tricuspid regurgitation;liver dysfunction;tricuspid valve replacement;MELD score