Morishita A, Tsuchiya K, Hosaka S, Sakahashi H, Iida Y
Department of Cardiovascular Surgery, Yamanashi Prefectural Central Hospital, Japan.
Kyobu Geka. 1995 Jan;48(1):80-3.
The etiology of the papillary muscle rupture includes myocardial infarction, trauma, hypertension, myxomatous degeneration, endocarditis etc. We report a case of partial papillary muscle rupture whose etiology was unknown, in a 77-year-old woman. The preoperative catheterization and coronary angiography showed severe mitral regurgitation and no significant coronary stenosis. And we recognized the mass waving into the left atrium in systole with the echocardiogram. At surgery, we repaired the mitral valve by resecting quadrangular areas of the posterior leaflet including the attachment of the torn papillary muscle. Additionally a number 28 Carpentier-Edwards mitral annuloplasty ring was sewn in place. In pathologic specimen, there were focal fibrosis, necrotic muscle, lymphocytes, and no vegetation.
乳头肌破裂的病因包括心肌梗死、创伤、高血压、黏液样变性、心内膜炎等。我们报告一例77岁女性乳头肌部分破裂的病例，其病因不明。术前心导管检查和冠状动脉造影显示严重二尖瓣反流且无明显冠状动脉狭窄。通过超声心动图我们识别出在收缩期有肿物摆动进入左心房。手术中，我们通过切除后叶的四边形区域（包括撕裂乳头肌的附着处）修复二尖瓣。此外，还缝合了一个28号的Carpentier-Edwards二尖瓣成形环。在病理标本中，有局灶性纤维化、坏死肌肉、淋巴细胞，且无赘生物。
