Traumatic Tricuspid Regurgitation Following Cardiac Massage

Abstract

We report a 66-yr-old male patient who developed tricuspid regurgitation secondary to internal cardiac massage. After uneventful off-pump coronary artery bypass surgery, the subject experienced cardiac arrest in the intensive care unit. External cardiac massage was initiated and internal cardiac massage was performed eventually. A transesophageal echocardiography revealed avulsion of the anterior papillary muscle and chordae to the anterior leaflet after successful cardiopulmonary resuscitation. Emergency repair of the papillary muscle was performed under cardiopulmonary bypass.

Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

“…Even though CPR-related cardiac rupture is rare, we should be aware of this complication [2]. One mechanism of valvular injury during CPR is thought to involve an abrupt elevation of ventricular pressure from a sudden compression of the heart when the atrioventricular valve is closed [19]. The reported frequency of each type of injury is highest for chordal rupture, followed by rupture of the papillary muscle and leaflet tear.…”