Oda Takeshi, Kono Takanori, Akaiwa Keiichi, Nakamura Katsuhiko
Department of Cardiovascular Surgery, Omura Municipal Hospital, Omura-city, Nagasaki, Japan.
Interact Cardiovasc Thorac Surg. 2018 Mar 1;26(3):529-531. doi: 10.1093/icvts/ivx365.
We report the case of a patient with severe mitral regurgitation who was diagnosed with double-orifice mitral valve by preoperative transthoracic and transoesophageal echocardiography. During surgery, it was revealed that the mitral valve was divided into 2 orifices, anterolateral and posteromedial, by a fibrous bridging tissue that was supported by the chordae tendineae originating from an accessory middle papillary muscle. The posterior scallop of the anterolateral orifice was prolapsed due to chordal elongation. Six interrupted sutures were made between the anterior leaflet and the posterior leaflet at the prolapsed site. Additional interrupted sutures were made at the sites of 2 clefts, and a ring annuloplasty was added. Residual mitral regurgitation was trivial, and the mean postoperative pressure gradient through each orifice was approximately 6 mmHg. To the best of our knowledge, this is the first case report of an edge-to-edge mitral repair for mitral regurgitation associated with a double-orifice mitral valve.
我们报告了一例严重二尖瓣反流患者，术前经胸和经食管超声心动图诊断为双孔二尖瓣。手术中发现，二尖瓣被一条纤维桥接组织分为两个孔，即前外侧孔和后内侧孔，该纤维桥接组织由起自副中间乳头肌的腱索支撑。前外侧孔的后叶瓣由于腱索延长而脱垂。在脱垂部位的前叶和后叶之间进行了6针间断缝合。在2个瓣裂处也进行了额外的间断缝合，并进行了瓣环成形术。二尖瓣反流残余极轻微，术后每个孔的平均压力阶差约为6 mmHg。据我们所知，这是第一例关于双孔二尖瓣相关二尖瓣反流的缘对缘二尖瓣修复病例报告。
