Surgical repair of traumatic tricuspid insufficiency: report of three cases.

Traumatic tricuspid insufficiency (TTI) is a rare lesion but is classically encountered as a "steering-wheel injury" in nonbelted car divers. This lesion is often not diagnosed because of its subtle clinical manifestations at first and the presence of associated injuries in multiple trauma. The majority of patients reported were treated with valve replacement but, more recently, successful repair of the native valve has made the latter the treatment of choice. Three patients were referred to us with a delayed diagnosis of TTI 2, 4, and 8 years after being involved in motor vehicle crashes (MVCs). Surgery was required and consisted of resuspension of the valvular leaflet with autogenous pericardium and ring annuloplasty. Two-dimensional echocardiography confirmed tricupid valve competence and the patients remained symptom free at a mean follow-up of 25 months.