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婴儿期吊床样二尖瓣的挑战:精确的术前高级成像和三维建模增强定制手术瓣膜重建

The Challenge of Hammock Mitral Valve During Infancy: Precise Preoperative Advanced Imaging and Three-Dimensional Modeling Augments Customized Operative Valve Reconstruction.

作者信息

VanLoozen Dennis, McCafferty Shawna, Lutin William A, Polimenakos Anastasios C

机构信息

Department of Pediatric Cardiology, Children's Hospital of Georgia, Augusta University, BA-8300, 1446 Harper Street, Augusta, GA, 30912, USA.

Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.

出版信息

Pediatr Cardiol. 2018 Mar;39(3):633-636. doi: 10.1007/s00246-017-1797-0. Epub 2017 Dec 22.

Abstract

Hammock mitral valve (MV), also known as anomalous mitral arcade, is a rare congenital anomaly. We report a case of a 10-month-old child who presented with congestive heart failure and was found to have severe mitral stenosis (MS) secondary to a hammock MV anomaly. Detailed advanced imaging with cardiac MRI and three-dimensional (3D) echocardiography favorably navigated a customized valve-sparing surgical reconstruction of the congenitally abnormal MV. Repair of a hammock MV is technically difficult with a guarded prognosis. Surgical experience is extremely limited and variable outcomes are reported. A rare case of severe MS secondary to hammock MV deformity with successful surgical repair and review of worldwide literature are presented.

摘要

吊床样二尖瓣(MV),也称为二尖瓣弓异常,是一种罕见的先天性异常。我们报告一例10个月大的儿童,表现为充血性心力衰竭,经检查发现因吊床样MV异常继发严重二尖瓣狭窄(MS)。心脏磁共振成像(MRI)和三维(3D)超声心动图等详细的高级成像技术成功地指导了对先天性异常MV进行定制的保留瓣膜手术重建。修复吊床样MV技术难度大,预后不佳。手术经验极其有限,报道的结果也各不相同。本文介绍了一例因吊床样MV畸形继发严重MS并成功进行手术修复的罕见病例以及对全球文献的综述。

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