Ugaki Shinya, Shimizu Toshikazu, Hongu Hisayuki, Nomura Kouji
Department of Cardiovascular Surgery, Saitama Children's Medical Center, Saitama, Japan.
Kyobu Geka. 2024 Mar;77(3):184-189.
Acute rupture of the chordae tendineae of the mitral valve could lead to severe mitral regurgitation and circulatory collapse in infants. Mitral valve replacement may be often challenging because of the valve-annulus size mismatch in small infants when mitral valve repair cannot be accomplished. We present an infant with acute massive rupture of the chordae tendineae of the mitral valve who successfully underwent supra-annular mitral valve replacement using the short composite valve of an expanded polytetrafluoroethylene( ePTFE) graft and a mechanical valve. His mechanical valve has been functioning without complications such as thrombosis and pulmonary venous obstruction for 20 months after surgery. This technique could be helpful even infants with acute rupture of the chordae tendineae of the mitral valve whose left atrium may not be dilated.
二尖瓣腱索急性断裂可导致婴儿严重二尖瓣反流和循环衰竭。由于小婴儿存在瓣环尺寸不匹配问题，在无法完成二尖瓣修复时，二尖瓣置换术往往具有挑战性。我们报告一例二尖瓣腱索急性大量断裂的婴儿，其成功接受了使用膨体聚四氟乙烯（ePTFE）移植物短复合瓣膜和机械瓣膜的瓣环上二尖瓣置换术。术后20个月，其机械瓣膜功能良好，未出现血栓形成和肺静脉阻塞等并发症。即使对于左心房可能未扩张的二尖瓣腱索急性断裂婴儿，该技术也可能有用。
