Effron M K
J Am Coll Cardiol. 1983 Apr;1(4):1018-23. doi: 10.1016/s0735-1097(83)80103-x.
Ten patients with aortic stenosis and ruptured mitral chordae tendineae constituted 8% of 125 consecutive surgical cases of chordal rupture. Their ages ranged from 54 to 87 years (mean 68). Six patients presented with acute onset of congestive heart failure, and eight were in New York Heart Association functional class III or IV at the time of cardiac catheterization. Extensive mitral anulus calcification was observed by fluoroscopy in seven patients. The mean aortic valve area index was 0.4 cm2/m2 and nine patients had moderate to severe mitral regurgitation by angiography. Calcific aortic stenosis affected a tricuspid valve in nine cases and a bicuspid valve in one case. One patient had a rheumatic mitral valve and one a redundant myxomatous mitral valve; the remaining eight had no abnormality of the mitral apparatus commonly regarded as predisposing to chordal rupture. Mitral anulus calcification and ventricular anatomic and hemodynamic alterations in aortic stenosis may contribute to rupture of the mitral chordae tendineae.
10例主动脉瓣狭窄合并二尖瓣腱索断裂患者占连续125例腱索断裂手术病例的8%。他们的年龄在54至87岁之间（平均68岁）。6例患者表现为充血性心力衰竭急性发作，8例在心脏导管检查时处于纽约心脏协会心功能Ⅲ级或Ⅳ级。7例患者经荧光透视观察到广泛的二尖瓣环钙化。平均主动脉瓣面积指数为0.4cm²/m²，9例患者经血管造影显示有中度至重度二尖瓣反流。钙化性主动脉瓣狭窄累及三尖瓣9例，累及二尖瓣1例。1例患者有风湿性二尖瓣，1例有多余的黏液瘤样二尖瓣；其余8例二尖瓣装置无通常被认为易导致腱索断裂的异常。主动脉瓣狭窄中的二尖瓣环钙化以及心室解剖和血流动力学改变可能导致二尖瓣腱索断裂。
