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房室间隔完整的双孔二尖瓣:一项结合解剖与功能考量的超声心动图研究

Double-orifice mitral valve with intact atrioventricular septum: an echocardiographic study with anatomic and functional considerations.

作者信息

Das Bibhuti B, Pauliks Linda B, Knudson Ole A, Kirby Scott, Chan Kak-Chen, Valdes-Cruz Lilliam, Cayre Raul O

机构信息

Children's Hospital, University of Colorado Health Sciences Center, Denver, Colorado, USA.

出版信息

J Am Soc Echocardiogr. 2005 Mar;18(3):231-6. doi: 10.1016/j.echo.2004.12.001.

Abstract

We identified 18 patients with double-orifice mitral valve (DOMV) and intact atrioventricular (AV) septum out of 40,179 echocardiographic studies performed between 1997 and 2002 at Children's Hospital, Denver, CO. In this study we describe (1) the anatomic characteristics of the DOMV in the absence of AV septal defect, (2) the function of the mitral valve by spectral and color Doppler flow mapping, and (3) associated lesions. The topographic location of the orifices in the leaflets suggests possible embryologic mechanisms of DOMV. In this series, DOMV was most commonly associated with left-sided obstructive lesions (in 39% of patients). Spectral and color Doppler interrogation demonstrated a normal flow profile in most cases; only 2 patients had significant mitral regurgitation or stenosis. Therefore, due to the uncertain natural history of this lesion and the potential need for endocarditis prophylaxis, careful imaging of the mitral valve is recommended, particularly in the presence of left-sided obstructive lesions.

摘要

在1997年至2002年间于科罗拉多州丹佛市儿童医院进行的40179次超声心动图检查中,我们识别出18例双孔二尖瓣(DOMV)且房室(AV)间隔完整的患者。在本研究中,我们描述了(1)无房室间隔缺损时DOMV的解剖特征,(2)通过频谱和彩色多普勒血流图分析二尖瓣的功能,以及(3)相关病变。瓣叶上孔的地形位置提示了DOMV可能的胚胎学机制。在本系列研究中,DOMV最常与左侧梗阻性病变相关(39%的患者)。频谱和彩色多普勒检查在大多数情况下显示血流形态正常;仅有2例患者存在明显的二尖瓣反流或狭窄。因此,鉴于该病变自然病史的不确定性以及潜在的感染性心内膜炎预防需求,建议对二尖瓣进行仔细成像,尤其是在存在左侧梗阻性病变的情况下。

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