Severe left-to-right shunting from combined traumatic tricuspid valve rupture and atrial septal defect: bridge to surgical repair using veno-venous ECMO.

Our patient presented to the emergency room following a motor vehicle accident. The traumatic tricuspid valve rupture was diagnosed by transthoracic echocardiogram, and his respiratory status declined rapidly. He was placed on veno-venous extracorporeal membrane oxygenation (VV ECMO) to bridge him to surgical repair. Transoesophageal echocardiography revealed a large atrial septal defect (ASD) with the combination of both injuries leading to severe left-to-right shunting that was underappreciated in the initial management of the patient. The tricuspid valve and the ASD were repaired. In this patient, in the context of both tricuspid valve rupture and ASD, veno-arterial ECMO or percutaneous right ventricular assist devices may have also helped bridge the patient to surgical repair of his blunt cardiac injuries.