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导致瓣膜渗漏的束带:左心房纤维束带所致严重二尖瓣反流——病例报告及文献综述

A Band That Causes Leaky Valves: Severe Mitral Regurgitation due to Left Atrial Fibrous Band-A Case Report and Literature Review.

作者信息

Nnaoma Christopher, Sandhu Gurdarshan, Sossou Christoph, Vavilin Ilan, Bustillo Jose, Garg Anshu

机构信息

Newark Beth Israel Medical Center, Newark, NJ, USA.

St. George's University, Grenada.

出版信息

Case Rep Cardiol. 2019 Mar 19;2019:2458569. doi: 10.1155/2019/2458569. eCollection 2019.

Abstract

Left atrial fibrous band is a rare clinical and echocardiographic finding characterized by the presence of a fibrous band attached to the mitral valve. Diagnosis is accomplished with transesophageal echocardiography (TEE), live 3D imaging, or cardiac MRI. Most patients are asymptomatic and incidental findings. However, in rare cases, an atrial fibrous band can produce symptoms such as dyspnea on exertion, fatigue, and lightheadedness secondary to mitral regurgitation (MR) which can lead to heart failure if unattended to. More serious complications such as cardioembolic phenomenon can occur. We herein report a case of a 55-year-old male with hypertension who presented with dyspnea on exertion and chest pain. Transthoracic echocardiography (TTE) showed mitral valve prolapse with moderate to severe mitral regurgitation. TEE showed an atrial fibrous band. Given the patient's poor exercise tolerance, he was taken to surgery for a mitral annuloplasty.

摘要

左心房纤维带是一种罕见的临床和超声心动图表现,其特征是存在一条附着于二尖瓣的纤维带。通过经食管超声心动图(TEE)、实时三维成像或心脏磁共振成像可完成诊断。大多数患者无症状,为偶然发现。然而,在罕见情况下,心房纤维带可导致劳力性呼吸困难、疲劳和头晕等症状,继发于二尖瓣反流(MR),若不加以处理可导致心力衰竭。还可能发生更严重的并发症,如心脏栓塞现象。我们在此报告一例55岁男性高血压患者,其出现劳力性呼吸困难和胸痛。经胸超声心动图(TTE)显示二尖瓣脱垂伴中度至重度二尖瓣反流。TEE显示心房纤维带。鉴于患者运动耐量差,遂接受二尖瓣环成形术手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f2e/6444234/71ca445fbea4/CRIC2019-2458569.001.jpg

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