Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guoxue Street, Wuhou District, Chengdu, 610041, China.
BMC Surg. 2022 May 21;22(1):199. doi: 10.1186/s12893-022-01636-6.
Percutaneous balloon mitral valvotomy is a common therapeutic approach for rheumatic mitral stenosis. Avulsion of the papillary muscle is a rare but serious complication of balloon mitral valvotomy. The papillary muscles are derived from the trabecular layer of the developing ventricular walls. When subjected to a force, avulsion of papillary muscle from the trabecular layer may occur.
In this case report, we describe a patient with rheumatic mitral stenosis, who experienced avulsion of the mitral papillary muscle from the left ventricular wall after undergoing balloon mitral valvotomy. Papillary muscle alvusion resulted in severe mitral regurgitation, which was finally treated by mitral valve replacement.
We successfully diagnosed avulsion of the papillary muscle following balloon mitral valvotomy. Three-dimensional transthoracic echocardiography provides more information on mitral apparatus structure than two-dimensional transthoracic echocardiography.
经皮二尖瓣球囊成形术是治疗风湿性二尖瓣狭窄的常用方法。乳头肌撕脱是二尖瓣球囊成形术的一种罕见但严重的并发症。乳头肌起源于心室壁的小梁层。当受到外力时，乳头肌可能会从小梁层撕脱。
本病例报告描述了一位风湿性二尖瓣狭窄患者，在接受二尖瓣球囊成形术后，左心室壁的二尖瓣乳头肌撕脱。乳头肌撕脱导致严重的二尖瓣反流，最终通过二尖瓣置换术进行治疗。
我们成功诊断了二尖瓣球囊成形术后的乳头肌撕脱。三维经胸超声心动图比二维经胸超声心动图提供了更多的二尖瓣装置结构信息。
