Tecklenberg P L, Alderman E L, Billingham M E, Shumway N E
Am J Med. 1978 Apr;64(4):707-14. doi: 10.1016/0002-9343(78)90594-6.
An unusual case of diverticulum of the left ventricle is presented. The most distinctive feature was the presence of a circumferential mid-ventricular contraction ring with histologic abnormalities similar to those described in patients with asymmetric septal hypertrophy. This abnormal ring of tissue obstructed emptying of the ventricular apex and isolated it from the rest of the ventricle. The obstructed apex assumed the appearance of a muscular diverticulum, and the residual portion of the ventricle was markedly diminished in volume. In addition, the abnormal mid-ventricular hypertrophy interfered with papillary muscle function, producing mitral valve prolapse and mitral regurgitation. The patient's age was equally unusual; she was 65 at the time of diagnosis, probably the oldest known patient with ventricular diverticulum. She was treated surgically by transapical myotomy and myectomy of the mid-ventricular contraction ring, in order to increase effective ventricular volume. The relationship of this entity to other types of ventricular deiverticula and aneurysms, and to hypertrophic cardiomyopathy, is discussed.
本文介绍了一例罕见的左心室憩室病例。最显著的特征是存在一个心室中部的环形收缩环，其组织学异常与不对称性室间隔肥厚患者中所描述的相似。这个异常的组织环阻碍了心尖部排空，并使其与心室其余部分隔离。受阻的心尖部呈现出肌肉性憩室的外观，而心室的剩余部分体积明显减小。此外，异常的心室中部肥厚干扰了乳头肌功能，导致二尖瓣脱垂和二尖瓣反流。患者的年龄也同样不同寻常；诊断时她65岁，可能是已知年龄最大的心室憩室患者。为了增加有效心室容积，她接受了经心尖心肌切开术和心室中部收缩环切除术的手术治疗。本文还讨论了该病症与其他类型的心室憩室、室壁瘤以及肥厚型心肌病的关系。
