Arikawa K, Saigenji H, Koga M, Nakamura K, Morishita Y, Taira A
Second Department of Surgery, Kagoshima University School of Medicine, Japan.
Jpn Circ J. 1987 Nov;51(11):1341-4. doi: 10.1253/jcj.51.1341.
Three cases with typical cooing murmurs in degenerated porcine valves at mitral positions were studied. An echophonocardiogram disclosed that the origin of cooing murmur was due to cusp vibration with fixed cycle in frequency. Three failed xenografts were replaced with mechanical valves and the removed prostheses were examined. The first valve had a torn cusp, the second had a perforated cusp and the third had both a torn and perforated cusps. The failed leaflets were all pliable and not thickened in properties. These common findings are suspected to relate closely to the occurrence of a musical cooing murmur. Since all cases with cooing murmurs suddenly developed severe or progressive heart failure, we recommend prompt evaluation and reoperation when a cooing murmur appears in the patients with xenografts.
研究了3例二尖瓣位置猪瓣膜退变出现典型鸽鸣样杂音的病例。超声心动图显示，鸽鸣样杂音的起源是由于瓣叶以固定频率周期振动。3个失败的异种移植物被机械瓣膜替换，并对移除的假体进行了检查。第一个瓣膜有一个撕裂的瓣叶，第二个有一个穿孔的瓣叶，第三个有一个撕裂和穿孔的瓣叶。失败的瓣叶质地均柔韧且未增厚。这些常见发现被怀疑与音乐性鸽鸣样杂音的发生密切相关。由于所有有鸽鸣样杂音的病例均突然出现严重或进行性心力衰竭，我们建议当异种移植物患者出现鸽鸣样杂音时应及时评估并再次手术。
