This case highlights the importance of continued clinical and echocardiographic vigilance after severe blunt cardiac injury, particularly for detecting late-emerging structural complications such as aneurysm formation and valvular dysfunction, and illustrates the potential utility of VA-ECMO as a bridging strategy before surgical repair of traumatic cardiac rupture.
A patient developed rupture of a posterior left ventricular aneurysm 54 days after a fall from a height.
The patient was emergently supported with VA-ECMO and then underwent surgical repair of the aneurysm.
Postoperative echocardiography revealed new-onset tricuspid chordae tendineae rupture, and the patient underwent elective mechanical tricuspid valve replacement.
Histopathology of the resected tricuspid valve tissue showed chronic degenerative changes.
The causal relationship and mechanism linking aneurysm repair or rupture to tricuspid chordal rupture remain uncertain, though the authors propose a potential pathophysiological connection.
The authors conclude that clinicians should maintain clinical and echocardiographic vigilance after severe blunt cardiac injury to detect late-emerging structural complications.
This case report describes a patient who suffered a serious blunt injury to the heart after a fall from a height. Fifty-four days later, a weakened bulge (aneurysm) in the back wall of the left ventricle ruptured. The patient was placed on VA-ECMO, a machine that temporarily takes over heart and lung function, and then had the aneurysm surgically repaired. After surgery, heart ultrasound showed that the cord-like supports of the tricuspid valve had newly ruptured, so the patient had the valve replaced with a mechanical one in a planned operation. Examination of the removed valve tissue showed long-standing degenerative changes. The authors believe this is the first report of this sequence of events, but they could not determine whether the aneurysm, its rupture, or its repair caused the valve problem. This research suggests that people who have had severe blunt heart injuries may need follow-up heart imaging for some time afterward, since complications can appear weeks later. It also suggests ECMO can serve as a bridge to surgery in such emergencies. Because this is a single case, these observations cannot prove cause and effect or show how often such events occur.
Shao H, Liao Y, Li Z. (2026). Tricuspid Chordae Tendineae Rupture Detected After Repair of a Delayed Traumatic Left Ventricular Aneurysm: A Case Report.. The American journal of case reports. https://doi.org/10.12659/AJCR.954932