Valvuloplasty to Treat Traumatic Aortic Regurgitation

  • Hitoshi OkabayashiEmail author


Blunt chest trauma commonly occurs during road traffic accidents in up to 20% of cases although traumatic aortic regurgitation (AR) is said to be rare. Reports indicate that cardiac injury is observed in 15–20% of autopsy cases, whereas valve injury is observed in 5% [1]. Valve injury may affect the aortic, mitral, or tricuspid valve. The most commonly observed lesions of the aortic valve (AV) in these cases are leaflet injury and disruption of the leaflets from the annulus, which most commonly affect the noncoronary cusp (NCC) [2–7]. The mechanism of AV injury involves the application of compressive force to the sternum from an anterior direction during early diastole; the aorta is compressed between the sternum and the vertebrae while the AV is closed, which leads to excessive pressure being exerted on the AV, thus causing injury [8]. There is speculation that the NCC might be more commonly injured because the leaflets with coronary ostia are able to avoid this pressure by diverting blood flow into the coronary arteries [9].


  1. 1.
    Prfere R, Chilcott M. Blunt trauma to the heart and great vessels. N Engl J Med. 1997;336:626–32.CrossRefGoogle Scholar
  2. 2.
    Traumatic valvular injury. CARPENTIER’S reconstructive valve surgery –from valve analysis to valve reconstruction. Philadelphia: Sunders Elsevier; 2010. p. 311–4.Google Scholar
  3. 3.
    Esmaeilzadeh M, Alimi H, Maleki M, Hosseini S. Aortic valve injury following blunt chest trauma. Res Cardiovasc Med. 2014;3:e17319.CrossRefGoogle Scholar
  4. 4.
    Egoh Y, Okoshi T, Anbe J, Akasaka T. Surgical treatment of traumatic rupture of the normal aortic valve. Eur J Cardiothorac Surg. 1997;11:1180–2.CrossRefGoogle Scholar
  5. 5.
    Kan CD, Yang YJ. Traumatic aortic and mitral valve injury following blunt chest injury with a variable clinical course. Heart. 2005;91:568–70.CrossRefGoogle Scholar
  6. 6.
    Vocke D, Moarof I, Matt P, Anabitarte P. Aortic valve rupture due to a motorcycle accident. Cardiovasc Med. 2011;14:192–4.CrossRefGoogle Scholar
  7. 7.
    Obadia JF, Tatou E, David M. Aortic valve regurgitation caused by blunt chest injury. Br Heart J. 1995;74:545–7.CrossRefGoogle Scholar
  8. 8.
    Matteucci ML, Rescigno G, Altamura G, Manfrin M, D'Alfonso A, Piccoli G, et al. Delayed traumatic aortic cusp detachment mimicking aortic dissection. Ann Thorac Surg. 2006;82:1093–5.CrossRefGoogle Scholar
  9. 9.
    Camarasa P, Berkane N, Joly L, Theissen MA, Carles M, Samat-Long C, et al. Safe and delayed repair in acute aortic traumatic insufficiency based on echocardiographic criteria. J Trauma. 2004;57:385–8.CrossRefGoogle Scholar
  10. 10.
    Girardi L, Isom OW. Repair of traumatic aortic valve disruption and descending aortic transection. Ann Thorac Surg. 2000;69:1251–3.CrossRefGoogle Scholar
  11. 11.
    Kin H, Minatoya K, Mukaida M, Okabayashi H. Successful valve repair in traumatic aortic valve regurgitation. Interact Cardiovasc Thorac Surg. 2011;12:869–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryMitsubishi Kyoto HospitalKyotoJapan

Personalised recommendations