Long Michael A, Med M
Department of Cardiothoracic Surgery, Faculty of Health Sciences, Free State University, Bloemfontein, South Africa.
J Card Surg. 2011 Jan;26(1):60-3. doi: 10.1111/j.1540-8191.2010.01157.x. Epub 2010 Nov 14.
An adult patient with advanced rheumatic heart disease undergoing chordal sparing mitral valve replacement as well as aortic valve replacement is presented. The patient developed an unusual complication of an infarction of the retained head of the anterolateral papillary muscle with subsequent spontaneous rupture 72-hours postoperatively. The ruptured head of the papillary muscle was successfully resected via an aortotomy through the aortic valve prosthesis. The patient made an uneventful recovery. Care to avoid excessive tension on the preserved chordae during mitral valve replacement, especially in the setting of chronic rheumatic carditis, is stressed.
本文介绍了一名患有晚期风湿性心脏病的成年患者，该患者接受了保留腱索的二尖瓣置换术以及主动脉瓣置换术。患者在术后72小时出现了一种不寻常的并发症，即保留的前外侧乳头肌头部梗死，随后发生自发性破裂。通过经主动脉瓣人工瓣膜的主动脉切口成功切除了破裂的乳头肌头部。患者术后恢复顺利。强调了在二尖瓣置换术中要注意避免对保留的腱索施加过大张力，尤其是在慢性风湿性心内膜炎的情况下。
