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创伤性二尖瓣反流:病例报告及最新研究进展综述。

Traumatic mitral valve regurgitation: a case report and state-of-the-art review.

机构信息

Clinical and Interventional Cardiology.

Cardiac surgery, Sassari University Hospital, Sassari, Italy.

出版信息

J Cardiovasc Med (Hagerstown). 2019 Oct;20(10):709-717. doi: 10.2459/JCM.0000000000000809.

Abstract

: Traumatic mitral valve regurgitation is a rare and often insidious condition. Clinical presentation is variable and influenced by the anatomic structures injured; when papillary muscles are damaged, the clinical presentation is often acute, whereas, in the case of involvement of other anatomic structures of the valvular apparatus (e.g. chordae tendinae), the onset of symptoms may be delayed (days, weeks, or months). Therefore, diagnosis may be belated because of the heterogeneous clinical presentation. Traumatic mitral valve injury should be excluded in patients admitted to the emergency services with blunt chest trauma, in particular when signs or symptoms of acute heart failure occur. Echocardiography, particularly with the transoesophageal approach, may play a pivotal role in this setting. Herein, we present a case of severe mitral regurgitation because of blunt chest trauma and a systematic review of the literature. We examined 192 described cases, classified according to epidemiology, aetiology, anatomic features, clinical presentation, diagnosis, surgical/clinical management and prognosis.

摘要

创伤性二尖瓣反流是一种罕见且常隐匿的疾病。临床表现多样,受损伤的解剖结构影响;当乳头肌受损时,临床表现通常为急性,而当瓣叶装置的其他解剖结构(如腱索)受累时,症状发作可能会延迟(数天、数周或数月)。因此,由于临床表现的异质性,诊断可能会延迟。在因钝性胸部创伤而入住急诊服务的患者中,应排除创伤性二尖瓣损伤,尤其是当出现急性心力衰竭的体征或症状时。超声心动图,特别是经食管途径,在这种情况下可能发挥关键作用。在此,我们报告了一例因钝性胸部创伤导致的严重二尖瓣反流,并对文献进行了系统回顾。我们检查了 192 例已描述的病例,根据流行病学、病因、解剖特征、临床表现、诊断、手术/临床管理和预后进行分类。

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