Scott-Jupp W, Barnett N L, Gallagher P J, Monro J L, Ross J K
J Pathol. 1981 Mar;133(3):185-201. doi: 10.1002/path.1711330303.
Mitral valves from ten patients with spontaneous rupture of mitral chordae were examined by light, scanning and transmission electron microscopy. Changes identified at rupture sites included oedema and necrosis of collagen, endothelial loss and, in some cases, partial or complete re-endothelialisation of the disrupted ends. With a solitary exception these abnormalities were confined to chordae which had actually ruptured. Some non-ruptured chordae were irregularly thinned and stretched but were normal by light and electron microscopy. Mucoid degeneration was almost invariable in mitral valve leaflets. These results suggest that spontaneous chordal rupture is more likely to be the result of abnormal mechanical strain rather than a diffuse connective tissue abnormality affecting multiple chordae. They may also provide theoretical justification for reconstruction rather than replacement of mitral valves in this condition.
对10例二尖瓣腱索自发性断裂患者的二尖瓣进行了光镜、扫描电镜和透射电镜检查。在断裂部位发现的变化包括胶原水肿和坏死、内皮细胞缺失，在某些情况下，断裂端部分或完全重新内皮化。除了一个单独的例外，这些异常仅限于实际断裂的腱索。一些未断裂的腱索不规则变薄和拉伸，但光镜和电镜检查显示正常。二尖瓣叶几乎总是出现黏液样变性。这些结果表明，自发性腱索断裂更可能是异常机械应变的结果，而不是影响多个腱索的弥漫性结缔组织异常。它们也可能为这种情况下二尖瓣的重建而非置换提供理论依据。
