射频导管消融术后延迟性乳头肌破裂：一例报告。
Delayed papillary muscle rupture after radiofrequency catheter ablation: A case report.
作者信息
Sun Ze-Wei, Wu Bi-Feng, Ying Xuan, Zhang Bi-Qi, Yao Lei, Zheng Liang-Rong
机构信息
Department of Cardiology, Zhejiang University, Hangzhou 310000, Zhejiang Province, China.
出版信息
World J Clin Cases. 2021 Jul 16;9(20):5556-5561. doi: 10.12998/wjcc.v9.i20.5556.
BACKGROUND
With an increased number of surgical procedures involving the mitral annular region, the risk of mitral valve prolapse (MVP) has also increased. Previous studies have reported that worsening of MVP occurred early after radiofrequency catheter ablation (RFCA) at papillary muscles in ventricular tachycardia (VT) patients with preoperative MVP.
CASE SUMMARY
We report a case where MVP and papillary muscle rupture occurred 2 wk after RFCA in a papillary muscle originated VT patient without mitral valve regurgitation or prolapse before. The patient then underwent mitral valve replacement with no premature ventricular contraction or VT. During the surgery, a papillary muscle rupture was identified. Pathological examination showed necrosis of the papillary muscle. The patient recovered after mitral valve replacement.
CONCLUSION
Too many ablation procedures and energy should be avoided.
背景
随着涉及二尖瓣环区域的外科手术数量增加，二尖瓣脱垂（MVP）的风险也有所上升。既往研究报道，术前存在MVP的室性心动过速（VT）患者在乳头肌行射频导管消融（RFCA）后，MVP早期会加重。
病例摘要
我们报告1例术前无二尖瓣反流或脱垂的乳头肌起源VT患者，在RFCA术后2周发生MVP和乳头肌破裂。该患者随后接受二尖瓣置换术，术后无室性早搏或VT发作。手术中发现乳头肌破裂。病理检查显示乳头肌坏死。二尖瓣置换术后患者康复。
结论
应避免过多的消融操作和能量。
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