Baehrel B, Gandjbakhch I, Sahnoun Y, Cham B, Etievent P, Guiraudon G, Cabrol C
Arch Mal Coeur Vaiss. 1978 Sep;71(9):982-90.
The authors report 70 cases of mitral regurgitation due to ballooning. For the surgeon this is the most frequent cause of degenerative mitral regurgitation in patients around 60-years-old. The aetiology still remains unknown. There are two opposing theories--the congenital and the acquired. The appearances at operation are characteristic--a localised or diffuse ballooning of one or both cusps with elongation of the chordae attached to the ballooned portion. Two histological features are noted--myxomatous degeneration of the cusp and the absence of any inflammatory process. Ballooning may be asymptomatic and bening for a long time before evolving progressively or suddenly into important mitral regurgitation. The pre-operative diagnosis is aided by left ventricular angiography and echocardiography. Surgical treatment, guided by the findings at operation, usually involves mitral valve replacement or, less frequently, mitral valve repair.
作者报告了70例因瓣叶膨出导致的二尖瓣反流病例。对于外科医生来说，这是60岁左右患者退行性二尖瓣反流最常见的原因。其病因仍然不明。有两种相反的理论——先天性和后天性。手术中的表现具有特征性——一个或两个瓣叶局部或弥漫性膨出，附着于膨出部分的腱索延长。有两个组织学特征——瓣叶黏液样变性和无任何炎症过程。瓣叶膨出可能在很长一段时间内无症状且为良性，然后逐渐或突然发展为严重的二尖瓣反流。术前诊断借助左心室血管造影和超声心动图。手术治疗根据术中发现进行指导，通常包括二尖瓣置换术，较少情况下为二尖瓣修复术。
