Trowitzsch E, Bano-Rodrigo A, Burger B M, Colan S D, Sanders S P
J Am Coll Cardiol. 1985 Aug;6(2):383-7. doi: 10.1016/s0735-1097(85)80176-5.
Between December 1981 and April 1984, five children ranging in age from 1 month to 5 1/2 years examined by two-dimensional echocardiography appeared to have a double orifice mitral valve. The diagnosis was verified in one patient at surgery, one patient by angiography and one patient by necropsy. Associated malformations included mitral stenosis and regurgitation, coarctation of the aorta, ostium primum and secundum atrial septal defect, ventricular septal defect and hypoplastic left heart syndrome. Three varieties of double orifice mitral valve were observed: an incomplete bridge type (one patient), in which a small strand of tissue connected the anterior and posterior leaflets at the leaflet edge level; a complete bridge type (three patients), in which a fibrous bridge divided the atrioventricular orifice completely into equal or unequal parts and a hole type (one patient), in which an additional orifice with subvalvular apparatus occurred in the posterior commissure of the mitral valve. These three types could be distinguished by sweeping the transducer in cross-sectional view from the apex toward the base of the heart. Both orifices could be seen throughout the scan in the complete bridge type while in the incomplete bridge type the two orifices could be seen only at the level of the papillary muscles. In the hole type, the second orifice was seen at about midleaflet level. In all three types, the chordae surrounding each orifice attached to only one papillary muscle. Congenital mitral stenosis or regurgitation was evident in three patients. The type of the double orifice mitral valve did not predict the presence or severity of symptoms.
在1981年12月至1984年4月期间，通过二维超声心动图检查的5名年龄在1个月至5岁半之间的儿童似乎患有双孔二尖瓣。1例患者在手术中确诊，1例通过血管造影确诊，1例通过尸检确诊。相关畸形包括二尖瓣狭窄和反流、主动脉缩窄、原发孔和继发孔房间隔缺损、室间隔缺损和左心发育不全综合征。观察到三种双孔二尖瓣类型：不完全桥接型（1例患者），其中一小束组织在瓣叶边缘水平连接前后瓣叶；完全桥接型（3例患者），其中纤维桥将房室口完全分为相等或不相等的部分；孔型（1例患者），其中二尖瓣后联合处出现带有瓣下装置的额外开口。通过将换能器从心尖向心底进行横断面扫查，可以区分这三种类型。在完全桥接型中，在整个扫查过程中都可以看到两个开口，而在不完全桥接型中，只有在乳头肌水平才能看到两个开口。在孔型中，第二个开口出现在瓣叶中部水平左右。在所有三种类型中，围绕每个开口的腱索仅附着于一个乳头肌。3例患者存在先天性二尖瓣狭窄或反流。双孔二尖瓣的类型并不能预测症状的存在或严重程度。
