Vaughn-Whitley K, Mooss A
Division of Cardiology, Creighton University School of Medicine, Omaha.
Chest. 1992 Nov;102(5):1618-9. doi: 10.1378/chest.102.5.1618.
A 48-year-old male patient underwent mitral annuloplasty for severe mitral regurgitation secondary to myxomatous degeneration of the mitral valve, with ruptured chordae. Intraoperative transesophageal echocardiography showed satisfactory repair. The patient developed postoperative atrial fibrillation and clinical and echocardiographic evidence of left ventricular outflow obstruction. Following conversion to sinus rhythm, the evidence for left ventricular outflow obstruction markedly improved. We suggest that postoperative atrial fibrillation may precipitate dynamic left ventricular outflow obstruction following mitral annuloplasty.
一名48岁男性患者因二尖瓣黏液瘤样变性继发严重二尖瓣反流伴腱索断裂，接受了二尖瓣环成形术。术中经食管超声心动图显示修复效果满意。患者术后出现房颤以及左心室流出道梗阻的临床和超声心动图证据。转为窦性心律后，左心室流出道梗阻的证据明显改善。我们认为，二尖瓣环成形术后房颤可能促使出现动态左心室流出道梗阻。
