Traumatic tricuspid regurgitation is a rare cardiovascular event that can follow blunt chest trauma. We report 2 cases of successful repair of traumatic tricuspid regurgitation. Case 1 : a 22-year-old man. At 18 years of age, he was involved in a falling accident. At the age of 19, he had an abnormal electrocardiogram and a cardiac murmur pointed out on a medical examination in his university. Echocardiography revealed severe tricuspid regurgitation, and he was referred to our institution for surgery. The operative findings showed some fenestrations in the anterior leaflet of the tricuspid valve. The fenestrations were sutured directly and ring annuloplasty was performed. Case 2 : a 54-year-old man. At age 18, he was involved in a falling accident. At age 31, he complained of fatigue and dyspnea. Echocardiography revealed severe tricuspid regurgitation. At age 54, liver dysfunction was discovered. He was referred to our institution for surgical treatment. In the operative findings, the chordae tendineae of the anterior and septal leaflets of the tricuspid valve were ruptured. Tricuspid valvuloplasty was performed using chordal replacement with 2 expanded polytetrafluoroethylene (CV-52^®) sutures, edge-to-edge sutures and ring annuloplasty.

A 74-year-old man presenting with general fatigue and dyspnea was admitted to another hospital. He was transferred to our hospital because his symptoms deteriorated and pericardial fluid increased. The symptoms did not improve even after percutaneous pericardial drainage. On a diagnosis of heart failure due to pericardial constriction, he underwent pericardiectomy. No hemodynamics improvement was found despite subtotal pericardiectomy. Multiple longitudinal and transverse incisions like a waffle were made in the thickened epicardium and improved the hemodynamics. The symptoms improved after sugery. Steroid therapy was effective after pathological examination of the excised epicardium that confirmed an emerging manifestation of hyper-IgG4 disease. We report a waffle procedure with good results for a constrictive pericarditis with hyper-IgG4 disease.

Given that the long head of the biceps femoris (BFlh), semitendinosus (ST), and semimembranosus (SM) have hip adduction moment arm, this study aimed to clarify the influence of hip abduction angle on their shear modulus, measured by using shear wave elastography, to determine an effective stretching position where these muscles are more elongated and demonstrate higher passive tension. Twelve healthy young men participated in the study. The shear modulus of BFlh, ST, and SM at the middle point was measured using shear wave elastography. The shear modulus was measured at hip abduction angles of 0°, 15°, 30°, and 45°, with the hip and knee joint held at 70° and 0° flexion, respectively. The effects of hip abduction angle on the muscle shear modulus were analyzed using a Friedman test, followed by Wilcoxon signed-rank tests with Benjamini-Hochberg procedure for post-hoc analysis. Effect sizes were calculated using r. Significant differences in shear modulus were found between hip abduction angles for all muscles (p < 0.05). Post-hoc analysis showed that the shear modulus of the SM at 45° was significantly higher compared to 0° (p < 0.05, r = 0.62) and 15° (p < 0.05, r = 0.54). For ST, the shear modulus at 45° was significantly higher compared to 0° (p < 0.05, r = 0.58). The shear modulus in BFlh at 15° was higher than 0° (p < 0.05, r = 0.53). Adding to hip abduction in a position of hip flexion and knee extension increases the shear modulus of the medial hamstrings, particularly the SM.