Deuvaert F E, Devriendt J, Massaut J, Van Nooten G, De Paepe J, Primo G
Service of Cardiac Surgery, Hôpital Universitaire Brugmann, ULB, Brussels, Belgium.
Acta Chir Belg. 1989 Jan-Feb;89(1):15-8.
This article reports a case of leaflet embolization of a mitral Edwards-Duromedics prosthesis. The patient had abrupt onset of acute pulmonary edema and was initially treated medically for 3 days. Fluoroscopy showed only one freely moving leaflet and the other was (incorrectly) assumed to be blocked in the closed position. The patient received IV thrombolysis for another 3 days and was finally operated. He died 8 days later from sepsis and the leaflet was recovered at autopsy in the abdominal aorta. Leaflet escape of a mitral Edwards-Duromedics prosthesis is a rare, potentially curable mode of valve failure. Correct interpretation of clinical signs and symptoms and of fluoroscopy should allow early diagnosis and surgical therapy.
本文报道了一例二尖瓣爱德华兹-杜罗美迪克人工瓣膜瓣叶栓塞的病例。患者突发急性肺水肿，最初接受了3天的药物治疗。荧光透视检查显示只有一个瓣叶可自由活动，另一个瓣叶（错误地）被认为在关闭位置受阻。患者又接受了3天的静脉溶栓治疗，最终接受了手术。他在8天后死于败血症，尸检时在腹主动脉中发现了瓣叶。二尖瓣爱德华兹-杜罗美迪克人工瓣膜的瓣叶脱出是一种罕见的、可能可治愈的瓣膜功能衰竭模式。对临床体征和症状以及荧光透视检查结果的正确解读应有助于早期诊断和手术治疗。
