Dupuy M, Marcheix B, Grunenwald E, Dickson Z, Cron C, Chauveau D
Service de Chirurgie Cardiovasculaire, Centre Hospitalo-Universitaire de Rangueil, Toulouse Cedex, France.
Ann Cardiol Angeiol (Paris). 2009 Jun;58(3):180-2. doi: 10.1016/j.ancard.2009.02.004. Epub 2009 Mar 12.
Wegener's granulomatosis (WG) is a granulomatous disease that can affect many organ systems. The most frequently involved organs include the upper and lower respiratory tract as well as the kidney. Cardiac involvement is rare.
We report the case of a patient with grade 4 mitral insufficiency associated with severe WG.
Surgical analysis of the mitral valve revealed perforation of the anterior leaflet without evidence of endocarditis. Pathological examination of the anterior mitral leaflet revealed myxoid degeneration nodules and bacteriological examination was negative. As the perforated lesion was very close to the free margin of the anterior leaflet, valve replacement appeared a reasonable surgical option in a poor surgical candidate. Six months after the operation, the patient is doing well.
Wegener's granulomatosis is an autoimmune necrotizing vasculitis that can affect many organ systems. Cardiac involvement is rare. Heart in his globality can be affected by WG in many different ways. Cardiac valvular involvement in WG is rare. The aortic valve seems to be more frequently affected. Cardiologic investigations should have an important place at diagnosis and supervision.
韦格纳肉芽肿（WG）是一种可累及多个器官系统的肉芽肿性疾病。最常受累的器官包括上、下呼吸道以及肾脏。心脏受累较为罕见。
我们报告一例患有4级二尖瓣关闭不全并伴有重症韦格纳肉芽肿的患者病例。
二尖瓣手术分析显示前叶穿孔，无感染性心内膜炎迹象。二尖瓣前叶病理检查显示黏液样变性结节，细菌学检查为阴性。由于穿孔病变非常靠近前叶游离缘，对于手术条件较差的患者，瓣膜置换似乎是合理的手术选择。术后六个月，患者情况良好。
韦格纳肉芽肿是一种可累及多个器官系统的自身免疫性坏死性血管炎。心脏受累较为罕见。心脏整体可通过多种不同方式受到韦格纳肉芽肿影响。韦格纳肉芽肿累及心脏瓣膜较为罕见。主动脉瓣似乎更常受累。心脏科检查在诊断和监测中应占据重要地位。
