Yuan Shi-Min, Shinfeld Amihay, Mishaly David, Haizler Rami, Ghosh Probal, Raanani Ehud
Department of Cardiac and Thoracic Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Card Surg. 2008 Nov-Dec;23(6):769-72. doi: 10.1111/j.1540-8191.2008.00633.x.
Accessory mitral valve tissue is an unusual congenital cardiac anomaly and a rare cause responsible for left ventricular outflow tract obstruction. An 18-year-old patient was referred to this hospital due to an occasionally noted heart murmur in a medical examination. Echocardiography facilitated the diagnosis of accessory mitral valve tissue. To relieve the left ventricular outflow tract obstruction, an operation including resection of the accessory mitral valve tissue, implantation of artificial chordae tendineae, and mitral valve annuloplasty was performed successfully. Postoperative echocardiography showed a complete relief of the mitral valve leaflets and a wide patent left ventricular outflow tract. However, transient ischemic attack and Horner's syndrome complicated the patient early postoperatively. He was administered with a high dose of aspirin, and he recovered shortly. Surgical removal is in so much mandatory as a definite diagnosis of accessory mitral valve tissue with left ventricular outflow tract obstruction is established. A prophylactic treatment should be applied to the patients with accessory mitral valve tissue in virtue of their susceptibility to neurological events.
二尖瓣附属组织是一种罕见的先天性心脏异常，是导致左心室流出道梗阻的罕见原因。一名18岁患者因体检偶尔发现心脏杂音而转诊至我院。超声心动图有助于诊断二尖瓣附属组织。为缓解左心室流出道梗阻，成功实施了包括切除二尖瓣附属组织、植入人工腱索和二尖瓣瓣环成形术在内的手术。术后超声心动图显示二尖瓣叶完全缓解，左心室流出道广泛通畅。然而，短暂性脑缺血发作和霍纳综合征在术后早期使患者病情复杂化。给予高剂量阿司匹林后，他很快康复。一旦确诊二尖瓣附属组织合并左心室流出道梗阻，手术切除是非常必要的。鉴于二尖瓣附属组织患者易发生神经事件，应给予预防性治疗。
