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结节性硬化症伴瘢痕心肌瘤所致二尖瓣 Ebstein 畸形:极罕见的二尖瓣关闭不全病因。

Mitral Ebstein's Anomaly Modified with a Scarred Rhabdomyoma in Tuberous Sclerosis: An Extremely Rare Cause of Mitral Insufficiency.

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, Japan.

Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Japan.

出版信息

Intern Med. 2021 Apr 15;60(8):1225-1229. doi: 10.2169/internalmedicine.6035-20. Epub 2020 Nov 23.

Abstract

We present an extremely rare case of mitral Ebstein's anomaly that resulted in severe mitral regurgitation (MR). A 41-year-old woman with a history of tuberous sclerosis underwent surgery. Preoperatively, it was assumed that MR had occurred due to leaflet tethering related to left ventricular posterior wall motion asynergy due to a scarred rhabdomyoma. However, surgical inspection revealed a dysplastic posterior leaflet adhering to the ventricular wall, which was completely covered by the endocardium. Both congenital mitral Ebstein's anomaly and acquired wall motion abnormality due to a scarred rhabdomyoma may have contributed to the development of severe MR in this case.

摘要

我们呈现了一例极其罕见的二尖瓣 Ebstein 畸形导致重度二尖瓣反流(MR)的病例。一名 41 岁的女性,有结节性硬化症病史,接受了手术治疗。术前,考虑到 MR 是由于左心室后壁运动不同步导致的瓣叶牵拉所致,这是由于瘢痕性横纹肌瘤引起的。然而,手术检查发现一个发育不良的后瓣叶附着在心室内壁上,完全被心内膜覆盖。在这种情况下,先天性二尖瓣 Ebstein 畸形和由于瘢痕性横纹肌瘤引起的心室壁运动异常都可能导致重度 MR 的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa03/8112993/27ab9613fe1c/1349-7235-60-1225-g001.jpg

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