Reid C L, Chandraratna A N, Harrison E, Kawanishi D T, Chandrasoma P, Nimalasuriya A, Rahimtoola S H
J Am Coll Cardiol. 1983 Sep;2(3):460-4. doi: 10.1016/s0735-1097(83)80272-1.
Aneurysm of the mitral valve occurs most commonly in association with infective endocarditis of the aortic valve. The probable mechanism of its formation is destruction of the aortic valve which results in a regurgitant jet that strikes the anterior leaflet of the mitral valve, creating a secondary site of infection leading to the development of an aneurysm. Perforation of these aneurysms may occur, resulting in mitral regurgitation and pulmonary edema from a ventricle already volume overloaded from aortic regurgitation. This report describes the clinical and echocardiographic-pathologic findings in five patients with pathologically proven aneurysm of the mitral valve. There are no clinical features that appear specific for this abnormality. The two-dimensional echocardiographic feature that is helpful in the diagnosis is a bulge of the mitral valve leaflet toward the left atrium that persists throughout the cardiac cycle. Preoperative diagnosis is important because a mitral valve aneurysm may produce serious complications and is frequently overlooked during surgery. Repair of the aneurysm may be feasible; otherwise, valve replacement becomes necessary. Careful two-dimensional echocardiographic examination should be done in patients with left-sided infective endocarditis to detect an aneurysm of the mitral valve.
二尖瓣动脉瘤最常与主动脉瓣感染性心内膜炎相关。其形成的可能机制是主动脉瓣破坏，导致反流束冲击二尖瓣前叶，形成继发感染部位，进而发展为动脉瘤。这些动脉瘤可能发生穿孔，导致二尖瓣反流以及因主动脉反流已使心室容量超负荷而引发肺水肿。本报告描述了5例经病理证实的二尖瓣动脉瘤患者的临床及超声心动图 - 病理检查结果。对于这种异常情况，没有特定的临床特征。有助于诊断的二维超声心动图特征是二尖瓣叶向左心房膨出，且在整个心动周期持续存在。术前诊断很重要，因为二尖瓣动脉瘤可能产生严重并发症，且在手术中常被忽视。动脉瘤修复可能可行；否则，就需要进行瓣膜置换。对于左侧感染性心内膜炎患者，应进行仔细的二维超声心动图检查以检测二尖瓣动脉瘤。
