Severe tricuspid insufficiency with rupture of the papillary muscle secondary to premature closure of ductus arteriosus: a case report

DOI
  • Izumi Kengo
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital Department of Pediatrics, Nayoro City General Hospital
  • Miyoshi Takamasa
    Department of Pediatrics, Wakkanai City Genaral Hospital
  • Sugiyama Tatsutoshi
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital
  • Aoyama Aiko
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital
  • Nii Mitsumaro
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital
  • Okamoto Toshio
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital
  • Nagaya Ken
    Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital

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Other Title
  • 乳頭筋断裂により重度三尖弁閉鎖不全を合併した動脈管早期閉鎖の一例

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<p> Clinical outcomes of premature closure of the ductus arteriosus（PCDA）range from mild symptom to lethal respiratory insufficiency and pulmonary hypertension. This report describes a newborn with severe tricuspid insufficiency with rupture of the papillary muscle and persistent pulmonary hypertension due to PCDA. A routine fetal examination at 28 weeks of gestation did not show any abnormalities. Soon after birth the baby developed severe respiratory distress and cyanosis. He was resuscitated immediate after birth, and transferred to our hospital at 5 hours of age. Intensive care, including mechanical ventilation, inhaled nitric oxide, and infusion of vasoactive agonist were required. He recovered, but tricuspid regurgitation persisted, presumably because of irreversible ischemic damage of one papillary muscle. This case highlights the importance of differentiating PCDA in newborns with prolonged hypoxia and early transfer to a tertiary care center.</p>

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