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[二尖瓣隔叶霉菌性动脉瘤的超声心动图诊断在主动脉瓣感染性心内膜炎中的重要性:手术意义]

[The importance of the echocardiographic diagnosis of a mycotic aneurysm of the mitral septal leaflet in infectious endocarditis of the aortic valve: the surgical implications].

作者信息

Delgado Ramis C, Martín Durán R, Vázquez de Prada J A, Gutiérrez J A, González Vílchez F, Ruano J, Olalla J J, Zarauza M J

机构信息

Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander.

出版信息

Rev Esp Cardiol. 1991 Dec;44(10):672-6.

PMID:1801096
Abstract

Mycotic aneurysm of the septal leaflet of the mitral valve is an infrequent complication associated with aortic infective endocarditis. The most probable mechanisms implicated on its formation are two: the lesion induced by regurgitant jet striking on septal mitral leaflet and the direct spreading of infection through the fibrosa inter-valvular. We describe the preoperative diagnosis of mycotic aneurysms of the septal mitral leaflet by two-dimensional echocardiography and color flow mapping in 2 patients. Surgical management will depend on the anatomic characteristics of the aneurysm and its hemodynamic repercussion. Careful echocardiographic search for mycotic mitral aneurysms should be performed in cases of aortic valve endocarditis, in view of its important prognostic implications.

摘要

二尖瓣隔叶霉菌性动脉瘤是与主动脉感染性心内膜炎相关的一种罕见并发症。其形成最可能涉及的机制有两个:反流束冲击二尖瓣隔叶所导致的病变,以及感染通过纤维性瓣膜间组织直接蔓延。我们描述了通过二维超声心动图和彩色血流图对2例患者二尖瓣隔叶霉菌性动脉瘤进行的术前诊断。手术治疗将取决于动脉瘤的解剖特征及其血流动力学影响。鉴于其重要的预后意义,对于主动脉瓣心内膜炎患者,应仔细进行超声心动图检查以寻找霉菌性二尖瓣动脉瘤。

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