Aortic regurgitation and sinus of Valsalva-right atrial fistula after blunt thoracic trauma

SUMMARY Non-penetrating chest trauma commonly causes a wide variety of cardiac injuries. Dis-ruption of the aortic valve with resultant aortic regurgitation is not uncommon; conversely, a sinus of Valsalva-right atrial fistula, in the absence of a congenital sinus of Valsalva aneurysm, has been reported only once previously. This report describes the detection by preoperative cardiac catheter-isation of both aortic regurgitation and a sinus of Valsalva-right atrial fistula after blunt chest trauma, and its surgical management. The need for preoperative cardiac catheterisation in patients suffering from non-penetrating cardiac trauma is emphasised, even when the diagnosis appears clear, because of the diverse nature and possible multiplicity of cardiac lesions. Non-penetrating chest trauma commonly causes car-diac injury, and a wide variety of anatomical derangements may ensue. I The most frequent valvu-lar lesion described in those who survive the trauma has been disruption of the aortic valve with resultant aortic regurgitation. ' A much less common lesion resulting from blunt trauma is a tear in the aortic wal