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[二尖瓣乳头肌断裂修补术;病例报告]

[Mitral valve repair for papillary muscle rupture; report of a case].

作者信息

Sugiyama Hironobu, Tobe Satoshi, Nousho Hiroki, Matsuo Tatsuro, Hayashi Taro, Yamaguchi Masahiro, Misato Takuya, Oka Takanori, Tanimura Nobuhiro

机构信息

Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Japan.

出版信息

Kyobu Geka. 2013 Jun;66(6):501-4.

Abstract

Papillary muscle rupture associated with acute myocardial infarction (AMI) is well known, but it's incidence is rare. We report a case of mitral valve repair with artificial chordae for partial papillary muscle rupture after AMI. A 75-year-old man underwent percutaneous coronary intervention(PCI) for right coronary artery because of AMI about 2 months ago at another hospital, and suffered from dyspnea 1 week after PCI. He had emergency admission to our hospital for cardiac failure. Echo-cardiogram revealed severe mitral regurgitation due to posterior papillary muscle rupture. We performed mitral valve repair with neochorda implantation to left ventricular wall of papillary muscle rupture site and ring annuloplasty. Mitral regurgitation was well controlled on postoperative echo-cardiogram. He was discharged at 25th postoperative day with no morbidity.

摘要

与急性心肌梗死(AMI)相关的乳头肌破裂是众所周知的,但发病率很低。我们报告1例急性心肌梗死后部分乳头肌破裂行人工腱索二尖瓣修复术的病例。一名75岁男性约2个月前在另一家医院因急性心肌梗死接受了右冠状动脉经皮冠状动脉介入治疗(PCI),PCI术后1周出现呼吸困难。他因心力衰竭紧急入住我院。超声心动图显示后乳头肌破裂导致严重二尖瓣反流。我们对乳头肌破裂部位的左心室壁进行了新腱索植入和瓣环成形术的二尖瓣修复。术后超声心动图显示二尖瓣反流得到良好控制。他术后第25天出院,无并发症。

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