Lellouche D, Francoual M, Usdin J P, Castaigne A, Estampes B, Montlouis E, Vernant P
Ann Med Interne (Paris). 1979;130(8-9):385-91.
Clinical findings and results of treatment in 17 patients with acute mitral incompetence are described. The lesions were secondary to a recent myocardial necrosis causing severe cardiac failure (shock, or acute left ventricular failure), and the presence of mitral incompetence was confirmed by right catherization (15 cases) and/or left ventricular angiography (13 cases). The anatomical lesions are described in 14 cases: rupture of the posterior mitral papillary muscle in 7 cases, and acute dysfunction of the muscle in 7 other cases. Eight patients were treated by an intra-aortic balloon to assist circulation, and 14 were given vasodilators (phentolamine, trinitrin) associated in 5 cases with positive inotropic drugs. Surgical treatment was given (mitral valve replacement) in 7 cases. The respective effects of vasodilators and circulatory assistance are discussed, as well as the indications for, and results of urgent surgical treatment (6 successes in 7 operations).
本文描述了17例急性二尖瓣关闭不全患者的临床症状及治疗结果。这些病变继发于近期的心肌坏死，导致严重心力衰竭（休克或急性左心室衰竭），通过右心导管检查（15例）和/或左心室血管造影（13例）证实存在二尖瓣关闭不全。14例描述了解剖学病变：7例为二尖瓣后乳头肌断裂，另7例为乳头肌急性功能障碍。8例患者接受主动脉内球囊辅助循环治疗，14例患者使用血管扩张剂（酚妥拉明、三硝酸甘油），其中5例联合使用正性肌力药物。7例患者接受了手术治疗（二尖瓣置换术）。文中讨论了血管扩张剂和循环辅助的各自效果，以及紧急手术治疗的适应症和结果（7例手术中有6例成功）。
