Lai Yu-Qiong, Huang Xin-Sheng, Wang Fei, Mo Zhan, Wu Li-Jie
Department of Cardiology, First People's Hospital of Foshan, Foshan 528000, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2009 Nov;29(11):2269-72.
To summarize the echocardiographic features of a wide spectrum of congenital mitral valve anomalies.
The medical records, echocardiograms, cardiac catheterization studies, and surgical reports were reviewed. The mitral valve anomalies evaluated in the study included parachute mitral valve, double orifice mitral valve, congenital mitral stenosis with 2 papillary muscles, anomalous papillary muscle rotation, and 3 commissures and papillary muscles in 15 cases. Surgeries were performed in 11 patients, and 1 patient underwent transcatheter closure of the patent ductus arteriosus.
The echocardiograms of 6 cases of parachute mitral valve were characterized by a hypoplastic mitral valve with short chordal attachments to a single posterior medial papillary muscle. The mitral valve demonstrated restricted motion. The double orifice mitral valve were featured by two separate mitral valve orifice, with each suborifice supported by its own tension apparatus in 4 patients. Asymmetric hypoplastic mitral valve stenosis with two papillary muscles was found in 1 patient with short and unbalanced chordal attachments to the anterior lateral major papillary muscle. Anomalous papillary muscle rotation was found in 1 patient. Mirtal anomaly with 3 major commissures and 3 papillary muscles was found in 3 patients.
Echocardiography offers clear demonstration of the mitral valve thickness and chordal attachments, and allows visualization of the position and the number of the papillary muscles and interpapillary spaces for evaluation of the mobility of the valve leaflets, therefore can be a valuable diagnostic modality for congenital mitral valve anomalies, especially congenital mitral stenosis.
总结多种先天性二尖瓣异常的超声心动图特征。
回顾病历、超声心动图、心导管检查研究及手术报告。本研究评估的二尖瓣异常包括降落伞样二尖瓣、双孔二尖瓣、伴有2个乳头肌的先天性二尖瓣狭窄、乳头肌异常旋转以及15例中有3个连合和乳头肌的情况。11例患者接受了手术,1例患者接受了动脉导管未闭的经导管封堵术。
6例降落伞样二尖瓣的超声心动图特征为二尖瓣发育不良,腱索短,附着于单个后内侧乳头肌。二尖瓣活动受限。4例双孔二尖瓣的特征为有两个独立的二尖瓣口,每个小孔有其自身的张力装置支持。1例患者发现不对称性发育不良二尖瓣狭窄,伴有两个乳头肌,其腱索短且附着于前外侧主要乳头肌,附着不均衡。1例患者发现乳头肌异常旋转。3例患者发现有3个主要连合和3个乳头肌的二尖瓣异常。
超声心动图能清晰显示二尖瓣厚度和腱索附着情况,可观察乳头肌位置、数量及乳头肌间间隙,以评估瓣叶活动度,因此对于先天性二尖瓣异常,尤其是先天性二尖瓣狭窄,是一种有价值的诊断方法。