退行性二尖瓣反流错位和限制性瓣环成形术的不良长期后果
Untoward Long-Term Consequences of Misplaced and Restrictive Annuloplasty for Degenerative Mitral Regurgitation.
作者信息
Sasaki Haruka, Takaoka Hiroyuki, Ishida Kazufumi, Takanashi Shuichiro, Kobayashi Yoshio
机构信息
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; Kawasaki Heart Center, Kawasaki Saiwai Hospital, Kawasaki, Japan.
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
出版信息
JACC Case Rep. 2025 Jun 11;30(14):103618. doi: 10.1016/j.jaccas.2025.103618.
BACKGROUND
Mitral stenosis after mitral valve repair for degenerative mitral regurgitation is a poor prognostic factor, but there are few reports of long-term postoperative course.
CASE SUMMARY
A 73-year-old man who had undergone mitral valve repair 24 years ago visited our hospital with shortness of breath. Exercise stress echocardiography induced mitral stenosis. Multimodality imaging with computed tomography (CT) and transesophageal echocardiography were really useful in detecting the abnormal location of the prosthetic valve ring causing mitral stenosis.
DISCUSSION
Wide-coverage CT and image processing using a new motion correction algorithm has allowed the visualization of highly mobile structures and thereby enabled more accurate assessment from previous assessments.
TAKE-HOME MESSAGES: The exercise stress test is useful in patients with discrepancies between symptoms, physical examination findings, and the examination results at rest. Morphologic evaluation of valve structures combined with CT and transesophageal echocardiography can provide a more detailed pathophysiologic assessment and understanding of causes.
背景
退行性二尖瓣反流二尖瓣修复术后二尖瓣狭窄是一个不良预后因素，但关于术后长期病程的报道较少。
病例摘要
一名24年前接受二尖瓣修复术的73岁男性因气短就诊我院。运动负荷超声心动图诱发二尖瓣狭窄。计算机断层扫描（CT）和经食管超声心动图的多模态成像在检测导致二尖瓣狭窄的人工瓣膜环异常位置方面非常有用。
讨论
广泛覆盖的CT和使用新的运动校正算法的图像处理能够可视化高度移动的结构，从而比以前的评估更准确地进行评估。
要点
运动负荷试验对症状、体格检查结果和静息检查结果存在差异的患者有用。结合CT和经食管超声心动图对瓣膜结构进行形态学评估可以提供更详细的病理生理评估并了解病因。
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