Treasure C B, Schoen F J, Treseler P A, Bittl J A
Department of Medicine (Cardiovascular Division), Brigham and Women's Hospital, Boston, Massachusetts 02115.
Clin Cardiol. 1989 Jul;12(7):405-8. doi: 10.1002/clc.4960120711.
Cusp entrapment is a previously unreported mechanism of aortic insufficiency after balloon aortic valvuloplasty. In a patient who developed severe acute aortic insufficiency and expired after balloon aortic valvuloplasty, pathologic evaluation revealed a large, solitary, fractured, calcific nodule in the noncoronary cusp in which the malaligned, irregular fracture surfaces of the nodule had entrapped the leaflet in an open position. The ease with which the entrapped leaflet was reduced by manipulation on postmortem examination suggests that further manipulation of the cusp might restore valve competence in some cases when aortic insufficiency occurs after balloon valvuloplasty in calcific aortic stenosis.
瓣叶嵌顿是球囊主动脉瓣成形术后一种此前未报道过的主动脉瓣关闭不全机制。在一名球囊主动脉瓣成形术后发生严重急性主动脉瓣关闭不全并死亡的患者中，病理评估发现无冠瓣叶有一个大的、孤立的、断裂的钙化结节，结节排列不齐、不规则的断裂面将瓣叶卡在开放位置。尸检时通过操作很容易将嵌顿的瓣叶复位，这表明在钙化性主动脉瓣狭窄患者球囊瓣膜成形术后发生主动脉瓣关闭不全时，在某些情况下进一步处理瓣叶可能恢复瓣膜功能。
