Smallhorn J F, de Leval M, Stark J, Somerville J, Taylor J F, Anderson R H, Macartney F J
Br Heart J. 1982 Aug;48(2):109-16. doi: 10.1136/hrt.48.2.109.
Five patients with isolated clefts in the anterior leaflet of the mitral valve, unassociated with atrioventricular septal defects, are described. All had significant mitral regurgitation, with the cleft being the only abnormality in three. Two patients had an associated ventricular septal defect, one with a straddling right atrioventricular valve. Angiocardiography in four showed moderate regurgitation, but was not able to delineate the aetiology. Two dimensional echocardiography showed a constant defect in the anterior leaflet, pointing towards the left ventricular outflow tract. This differed from 30 cases with atrioventricular septal defects where the "cleft" pointed towards the interventricular septum and was situated between the anterior and posterior bridging leaflets. All cases with isolated clefts had surgical correction, with minimal residual regurgitation on follow-up examination in two cases. Our current policy in patients with uncomplicated isolated cleft involves non-invasive assessment of these children and surgical correction if the regurgitation is significant.
本文描述了5例二尖瓣前叶孤立性裂缺且不伴有房室间隔缺损的患者。所有患者均有明显的二尖瓣反流，其中3例裂缺是唯一的异常。2例患者伴有室间隔缺损，1例伴有骑跨性右房室瓣。4例患者的心血管造影显示中度反流，但无法明确病因。二维超声心动图显示前叶存在恒定缺损，指向左心室流出道。这与30例房室间隔缺损患者不同，后者的“裂缺”指向室间隔，位于前后桥瓣之间。所有孤立性裂缺病例均接受了手术矫正，随访检查时2例患者的残余反流最小。我们目前对于单纯性孤立性裂缺患者的治疗策略是对这些儿童进行无创评估，若反流严重则进行手术矫正。
