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Brief communications 5 5 9 approach, and simple observation with high-dose intravenous antibiotics. 5 In a critical situation such as this case, however, less invasive treatment might be advisable. Urgent cerebral angiography and an endovascular approach to mycotic aneurysms, especially for solitary and peripheral lesions, is an acceptable option for some patients with active endocarditis and severely damaged hearts.

Traumatic tricuspid valve injury is rare, accounting for 0.02% of traumatic injuries. The majority of cases result from blunt force trauma to the chest, however penetrating injuries have been documented in literature. Patients' can be in the full spectrum of disease, from asymptomatic to cardiogenic shock. Indications for surgery include right heart failure or evidence of right heart volume overload in the setting of significant tricuspid regurgitation. Early surgical repair is warranted to preserve right ventricular function. Surgery also needs to be planned in conjunction with the patients' other injuries. In some cases, it may be beneficial for surgery to be delayed whilst the patient is closely observed, in order for the patient to recover from concomitant injuries. We report two cases of tricuspid regurgitation in the context of blunt trauma, and our approach to the management of these patients.

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