Rywik T, Sitkowski W, Cichocki J, Rajecka A, Suwalski K
2nd Department of Heart Valve Disease, Grochowski Municipal Hospital, Warsaw, Poland.
J Heart Valve Dis. 1995 May;4(3):293-5.
A 22-year-old male patient with penetrating cardiac injury was admitted to general surgery, where he underwent an immediate, life saving operation. Subsequent cardiological evaluation established the presence of a well tolerated mitral regurgitation without the need for urgent cardiac surgical intervention. One month later the patient was re-admitted in cardiac failure. Transesophageal echocardiography suggested the detachment of the posterior leaflet, which was not previously demonstrated by transthoracic echocardiography. Emergency surgery confirmed the diagnosis and the mitral valve was successfully repaired. The postoperative course was uneventful. This case history suggests that transesophageal echocardiography is mandatory after penetrating cardiac injury even in the case of good clinical condition and negative transthoracic echocardiographic findings. In the presence of valvular injury, early surgical intervention is recommended.
一名22岁男性穿透性心脏损伤患者被收入普通外科，在那里他接受了紧急的救命手术。随后的心脏评估确定存在耐受性良好的二尖瓣反流，无需紧急心脏手术干预。一个月后，患者因心力衰竭再次入院。经食管超声心动图提示后叶脱垂，而经胸超声心动图此前未显示这一情况。急诊手术证实了诊断，二尖瓣成功修复。术后过程顺利。该病例表明，即使临床状况良好且经胸超声心动图检查结果为阴性，穿透性心脏损伤后经食管超声心动图检查也是必要的。若存在瓣膜损伤，建议早期手术干预。
