Tanaka H, Horinouchi N, Hizukuri K, Fukuda Y, Kamikubo J, Kawaharada T, Tachibana H, Yamashita T, Yamashita M, Nakamura K
Department of Cardiovascular Surgery, National Hospital Kyushu Cardiovascular Center, Kagoshima.
J Cardiol. 2000 Oct;36(4):263-7.
Dysfunction of any mechanical prosthesis due to thrombus or pannus requires prompt definite diagnosis and therapy. A 55-year-old woman had received a prosthetic valve for aortic regurgitation 3 years before and was admitted for intermittent chest pain. Electrocardiography showed remarkable ST depression in broad leads during chest pain. Coronary angiography and cinefluoroscopy performed for definite diagnosis at the time of the third attack revealed no stenotic lesion in the coronary artery, but an artificial valve stuck in the completely open position. The diagnosis was acute aortic regurgitation caused by the stuck open valve. Urgent reoperation was performed. Abnormal proliferation of pannus trapping the artificial aortic valve was found at the left ventricular-side orifice of the prosthetic valve. Intermittent valvular sticking can cause acute aortic regurgitation and caused the symptomatic intermittent chest pain and ST depression in this patient.
任何机械瓣膜因血栓或血管翳出现功能障碍都需要迅速明确诊断并进行治疗。一名55岁女性3年前因主动脉瓣反流接受了人工瓣膜置换，现因间歇性胸痛入院。心电图显示胸痛发作时广泛导联ST段明显压低。第三次发作时进行冠状动脉造影和荧光透视以明确诊断，结果显示冠状动脉无狭窄病变，但人工瓣膜卡在完全开放位置。诊断为开放卡瓣所致急性主动脉瓣反流。遂紧急进行再次手术。在人工瓣膜左心室侧孔处发现血管翳异常增生并困住了人工主动脉瓣。间歇性瓣膜卡瓣可导致急性主动脉瓣反流，并引起该患者出现有症状的间歇性胸痛和ST段压低。
