Kitamura S, Kawashima Y, Kawachi K, Harima R, Ihara K, Nakano S, Shimazaki Y, Mori T
J Thorac Cardiovasc Surg. 1980 Oct;80(4):629-36.
Case histories are reported of three patients, 1 to 4 years of age, with severe mitral regurgitation that occurred as a sequela of mucocutaneous lymph node syndrome (MCLS). These patients were found among 12 patients with coronary artery lesions such as aneurysms, narrowings, and obstructions. One of them with multiple coronary aneurysms and also severely impaired left ventricular function died of congestive heart failure in the 2 years and 7 months' follow-up period after the acute illness. The second patient, 1 year of age, had multiple coronary aneurysms and mitral regurgitation. Because of the difficulty in treating coronary artery lesions at this patient's age and also because of medically controllable mitral regurgitation at present, this patient is now under careful observation. The third patient, whose condition was complicated by inferior wall myocardial infarction due to occlusion of the right coronary artery, underwent mitral valve replacement for intractable heart failure and cardiac cachexia. This patient had slow but definite improvement postoperatively. Mitral regurgitation secondary to MCLS usually is complicated by the associated difficult coronary artery lesions and impaired left ventricular function. Although this fact causes an extra-difficult situation, mitral regurgitation consequent to MCLS is amenable to surgical treatment and this disease should now be considered as a new surgical entity.
报告了3例1至4岁患有严重二尖瓣反流的患儿病例，该二尖瓣反流是皮肤黏膜淋巴结综合征（MCLS）的后遗症。这些患儿在12例患有冠状动脉病变（如动脉瘤、狭窄和阻塞）的患儿中被发现。其中1例患有多发性冠状动脉瘤且左心室功能严重受损，在急性病后2年7个月的随访期内因充血性心力衰竭死亡。第2例患儿1岁，患有多发性冠状动脉瘤和二尖瓣反流。由于该患儿年龄较小，治疗冠状动脉病变困难，且目前二尖瓣反流可通过药物控制，因此该患儿目前正在密切观察中。第3例患儿因右冠状动脉闭塞并发下壁心肌梗死，因难治性心力衰竭和心源性恶病质接受了二尖瓣置换术。该患儿术后恢复缓慢但有明显改善。MCLS继发的二尖瓣反流通常伴有相关的复杂冠状动脉病变和左心室功能受损。尽管这一情况使病情格外棘手，但MCLS所致的二尖瓣反流适合手术治疗，现在应将这种疾病视为一种新的外科疾病实体。
