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降落伞样二尖瓣伴二尖瓣反流的成功手术修复。

Successful surgical repair of the parachute mitral valve with mitral valve regurgitation.

作者信息

Shiraishi Manabu, Yamaguchi Atsushi, Adachi Hideo

机构信息

Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2012;18(6):569-72. doi: 10.5761/atcs.cr.11.01841. Epub 2012 May 15.

Abstract

A 65-year-old woman with exercise-related dyspnea was admitted to our hospital. Transthoracic echocardiography demonstrated a large anomalous papillary muscle that originated from the posterior wall of the left ventricle and severe mitral valve regurgitation in systole. Cleft suture, 5-0 polytetrafluoroethylene sutures from a single papillary muscle to the anterior commissure leaflet (AC), 5-0 polypropylene sutures between AC and A1, and between A1 and A2, the double-orifice technique, and ring plasty with 32-mm semi-rigid ring was performed. Postoperative echocardiography showed an improvement in severe mitral valve regurgitation. At the 2-month follow-up, the patient was in good health. In the present case, the elderly patient with an isolated parachute mitral valve but without any other cardiac anomaly and presenting with mitral valve regurgitation is extremely rare. This case of mitral valvuloplasty for a parachute mitral valve with a single papillary muscle in an elderly woman has not been reported before.

摘要

一名65岁有运动相关呼吸困难的女性入住我院。经胸超声心动图显示一个源自左心室后壁的巨大异常乳头肌以及收缩期严重二尖瓣反流。采用5-0聚四氟乙烯缝线从单个乳头肌至前联合瓣叶(AC)进行裂隙缝合,在AC与A1之间以及A1与A2之间采用5-0聚丙烯缝线,采用双孔技术,并使用32毫米半刚性环进行环成形术。术后超声心动图显示严重二尖瓣反流有所改善。在2个月的随访中,患者健康状况良好。在本病例中,老年患者患有孤立性降落伞样二尖瓣但无任何其他心脏异常且伴有二尖瓣反流极为罕见。此前尚未报道过针对老年女性单乳头肌降落伞样二尖瓣进行二尖瓣成形术的该病例。

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