Vogt J, Eckhardt R, Beuren A J
Z Kardiol. 1975 Jun;64(6):516-35.
Thirty-three patients with congenital mitral stenosis are presented. Congenital mitral stenosis occurs as an isolated malformation and in combination with additional cardiac lesions. A new classification into 5 groups is suggested. It is possible to classify congenital mitral stenosis with and without additional lesions according to these 5 groups. This is of particular clinical advantage. Isolated congenital mitral stenosis is a rare malformation. In combination with additional obstructive left-sided cardiac malformations mitral stenosis occurs more frequently. In infancy and early childhood the so-called parachute valve is a stenotic lesion. According to our experience the parachute valve tends to the development of additional mitral incompetence in older children. This observation is of clinical and diagnostic importance. In patients with additional valvular aortic stenosis the mortality is very high. The operative treatment of congenital mitral stenosis with a parachute valve in combination with other obstructive lesions of the left ventricular outflow tract and the aorta without removal of the parachute valve seems to be unable to improve the hemodynamic situation and the prognosis of these patients. There is not enough experience with artificial valves in congenital mitral stenosis in early childhood.
本文报告了33例先天性二尖瓣狭窄患者。先天性二尖瓣狭窄可作为孤立畸形出现，也可与其他心脏病变合并存在。建议将其重新分为5组。根据这5组可以对有无其他病变的先天性二尖瓣狭窄进行分类。这具有特别的临床优势。孤立性先天性二尖瓣狭窄是一种罕见的畸形。与其他左侧心脏梗阻性畸形合并时，二尖瓣狭窄更常见。在婴儿期和幼儿期，所谓的降落伞瓣是一种狭窄病变。根据我们的经验，降落伞瓣在大龄儿童中易发展为额外的二尖瓣关闭不全。这一观察结果具有临床和诊断意义。合并瓣膜性主动脉狭窄的患者死亡率很高。对于先天性二尖瓣狭窄合并降落伞瓣以及左心室流出道和主动脉其他梗阻性病变的患者，在不移除降落伞瓣的情况下进行手术治疗似乎无法改善血流动力学状况和患者预后。在幼儿先天性二尖瓣狭窄中使用人工瓣膜的经验不足。
