Laceration of a mitral papillary muscle and the aortic root as a result of blunt trauma to the chest. Case report and review of the literature

A case is presented of a steering wheel injury to the chest, in which the initial clue to significant cardiac injury was a new murmur and abnormal electrocardiogram. Precise preoperative echocardiographic evaluation revealed a combination of injuries consisting of (1) mitral incompetence secondary to partial laceration of a papillary muscle, (2) circumferential laceration of the aortic root contained by the adventitia, and (3) rupture of the pericardium. Operative correction of the mitral and aortic root lesions was performed 9 days after the injury. Twelve other cases of successful surgical correction of traumatic mitral incompetence are reviewed and compared.