Aoyagi S, Fukunaga S, Oishi K
Second Department of Surgery, Kurume University School of Medicine, Japan.
J Heart Valve Dis. 1995 Jan;4(1):99-102.
Two cases of severe aortic regurgitation due to non-traumatic rupture of the aortic valve commissures are reported. The cause of rupture was hypertension in one patient, but it could not be identified in the other, where microscopic examinations of the aortic wall and the aortic cusps showed no particular pathologic changes. M-mode echocardiography revealed enlargement of the left ventricle, diastolic flutter of the anterior mitral leaflet and diastolic separation of the closure line of the aortic cusps in both patients. Two-dimensional echocardiography showed a downward displacement of the prolapsing motion of the aortic valve cusp during diastole toward the left ventricular outflow tract in one patient, and eccentricity of the coaptation point of the aortic valve without thickening of the cusps in the other. In addition to clinical features of progressive heart failure and characteristic cardiac murmur, echocardiographic studies provided correct diagnosis of aortic valve prolapse resulting from rupture of the aortic valve commissures. Both patients underwent aortic valve replacement successfully.
本文报告了两例因主动脉瓣连合部非创伤性破裂导致的严重主动脉瓣反流病例。其中一例患者破裂原因是高血压，但另一例患者的破裂原因无法确定，该患者的主动脉壁和主动脉瓣尖的显微镜检查未发现特殊病理变化。M型超声心动图显示，两名患者均有左心室扩大、二尖瓣前叶舒张期扑动和主动脉瓣关闭线舒张期分离。二维超声心动图显示，一名患者在舒张期主动脉瓣尖脱垂运动向下移位至左心室流出道，另一名患者主动脉瓣对合点偏心，瓣尖未增厚。除了进行性心力衰竭的临床特征和特征性心脏杂音外，超声心动图检查还对主动脉瓣连合部破裂导致的主动脉瓣脱垂做出了正确诊断。两名患者均成功接受了主动脉瓣置换术。
