Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA.
Am J Cardiol. 2012 Jan 15;109(2):263-71. doi: 10.1016/j.amjcard.2011.09.002. Epub 2011 Oct 22.
Although bicuspid aortic valve occurs in an estimated 1% of adults and mitral valve prolapse in an estimated 5% of adults, occurrence of the 2 in the same patient is infrequent. During examination of operatively excised aortic and mitral valves because of dysfunction (stenosis and/or regurgitation), we encountered 16 patients who had congenitally bicuspid aortic valves associated with various types of dysfunctioning mitral valves. Eleven of the 16 patients had aortic stenosis (AS): 5 of them also had mitral stenosis, of rheumatic origin in 4 and secondary to mitral annular calcium in 1; the other 6 with aortic stenosis had pure mitral regurgitation (MR) secondary to mitral valve prolapse in 3, to ischemia in 2, and to unclear origin in 1. Of the 5 patients with pure aortic regurgitation, each also had pure mitral regurgitation: in 1 secondary to mitral valve prolapse and in 4 secondary to infective endocarditis. In conclusion, various types of mitral dysfunction severe enough to warrant mitral valve replacement occur in patients with bicuspid aortic valves. A proper search for mitral valve dysfunction in patients with bicuspid aortic valves appears warranted.
虽然二叶式主动脉瓣在估计 1%的成年人中发生，二尖瓣脱垂在估计 5%的成年人中发生，但在同一患者中同时发生这两种情况并不常见。在因功能障碍（狭窄和/或反流）而对手术切除的主动脉瓣和二尖瓣进行检查时，我们遇到了 16 名患有先天性二叶式主动脉瓣并伴有各种类型的二尖瓣功能障碍的患者。这 16 名患者中有 11 名患有主动脉瓣狭窄 (AS)：其中 5 名患者同时患有二尖瓣狭窄，4 名由风湿性心脏病引起，1 名由二尖瓣环钙沉积引起；另外 6 名主动脉瓣狭窄患者的二尖瓣反流为单纯性（MR），其中 3 名继发于二尖瓣脱垂，2 名继发于缺血性心脏病，1 名原因不明。在 5 名单纯性主动脉瓣反流患者中，每位患者也都有单纯性二尖瓣反流：1 名继发于二尖瓣脱垂，4 名继发于感染性心内膜炎。总之，在二叶式主动脉瓣患者中，会出现足以需要二尖瓣置换的各种类型的严重二尖瓣功能障碍。对二叶式主动脉瓣患者进行二尖瓣功能障碍的适当检查似乎是必要的。
