Bilal M S, Oztunç F, Beşikçi R, Bilal S, Ozkara A, Olga R
University of Istanbul, Institute of Cardiology, Turkey.
Thorac Cardiovasc Surg. 1999 Aug;47(4):252-5. doi: 10.1055/s-2007-1013154.
We report an unusual case of left-ventricular outflow obstruction caused by accessory mitral valve tissue associated with dextrocardia and ventricular septal defect in a seven-day-old, 2200 grams premature infant, who was referred with a heart murmur. The diagnosis was made by two-dimensional and Doppler echocardiography which demonstrated the accessory tissue as well as a 100 mmHg peak systolic gradient between the left ventricle and the aorta. Ten days after the presentation the infant underwent emergency surgery after respiratory arrest and recurrent episodes of syncope. The accessory mitral valve tissue and its fibrous extension were excised and the ventricular septal defect was closed. We believe that surgical treatment of patients with accessory mitral valve tissue should be performed early because of the possibility of acute deterioration. Combined aortotomy and interatrial approach is very helpful in evaluating the anatomy and the mitral valve function as well as delineating the tissue to be excised.
我们报告了一例罕见病例，一名7天大、体重2200克的早产儿因右位心和室间隔缺损合并副二尖瓣组织导致左心室流出道梗阻，该患儿因心脏杂音前来就诊。通过二维和多普勒超声心动图做出诊断，显示出副二尖瓣组织以及左心室与主动脉之间100 mmHg的收缩期峰值压差。就诊10天后，该婴儿在呼吸骤停和反复晕厥发作后接受了急诊手术。切除了副二尖瓣组织及其纤维延伸部分，并关闭了室间隔缺损。我们认为，由于存在急性病情恶化的可能性，对于有副二尖瓣组织的患者应尽早进行手术治疗。联合主动脉切开术和心房入路对于评估解剖结构和二尖瓣功能以及确定要切除的组织非常有帮助。
