Nomeir A M, Downes T R, Cordell A R
Department of Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
J Am Soc Echocardiogr. 1992 Mar-Apr;5(2):195-8. doi: 10.1016/s0894-7317(14)80553-1.
Perforation of the mitral valve as a result of aortic valve endocarditis is rare. Recognition of such abnormality is very important before surgical intervention. Diagnosis is very difficult by either invasive or noninvasive techniques. This report stresses the role of echocardiography in evaluating this rare abnormality. Perforation of the anterior mitral valve leaflet developed in our patient as a complication of aortic valve endocarditis. The perforation was suggested by the surface echocardiogram (as an interruption of the leaflet continuity) and by the color flow Doppler (which suggested turbulent flow at the area of suspected interruption). The perforation was confirmed during surgery by transesophageal echocardiography and alerted the surgeon to repair, rather than replace, the valve.
主动脉瓣心内膜炎导致二尖瓣穿孔的情况较为罕见。在进行手术干预之前，识别这种异常情况非常重要。无论是通过有创还是无创技术，诊断都非常困难。本报告强调了超声心动图在评估这种罕见异常情况中的作用。我们的患者出现了前叶二尖瓣穿孔，这是主动脉瓣心内膜炎的一种并发症。表面超声心动图（显示瓣叶连续性中断）和彩色多普勒血流显像（提示在疑似中断区域存在湍流）提示了穿孔的存在。手术过程中经食管超声心动图证实了穿孔，提醒外科医生对瓣膜进行修复而非置换。
