Tachibana Hitoshi, Okusako Ryo, Oshita Mayo, Arakawa Miwa, Katayama Akira, Takahashi Shinya
Department of Cardiovascular Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Kyobu Geka. 2021 Mar;74(3):213-216.
An 83-year-old woman with congestive heart failure due to severe mitral regurgitation was referred to our department. Because acute coronary syndrome was suspected, the patient underwent emergent coronary artery angiography, which showed 75% stenosis of segment 2 and 90% stenosis of segment 11. Subsequently, segment 11 was treated by percutaneous coronary intervention. Additionally, transesophageal echocardiography findings showed a prolapse of P2 due to papillary muscle rupture. After management of heart failure, a scheduled operation was performed under the diagnosis of acute mitral regurgitation due to papillary muscle rupture. Intraoperative findings demonstrated a rupture of the anterior papillary muscle, prolapse of P2, and no evidence of infection. The patient underwent mitral valve repair with artificial chordae through median sternotomy. Her postoperative course was uneventful.
一名83岁因严重二尖瓣反流导致充血性心力衰竭的女性被转诊至我科。由于怀疑患有急性冠状动脉综合征,该患者接受了紧急冠状动脉造影,结果显示第2节段狭窄75%,第11节段狭窄90%。随后,第11节段接受了经皮冠状动脉介入治疗。此外,经食管超声心动图检查结果显示因乳头肌破裂导致P2脱垂。在心力衰竭得到处理后,在因乳头肌破裂导致急性二尖瓣反流的诊断下进行了预定手术。术中发现显示前乳头肌破裂、P2脱垂,且无感染迹象。患者通过正中胸骨切开术使用人工腱索进行了二尖瓣修复。术后恢复过程顺利。