Schwarze E W, Bernhard A
Virchows Arch A Pathol Anat Histol. 1975 Jul 17;367(2):149-62. doi: 10.1007/BF00430952.
The special pathology of reconstructable or only prosthetically correctable congenital malformations of the mitral valve is described on the basis of the following examples taken from our own operative and autopsy material of the last 5 years: 1. Congenital isolated mitral stenosis in female twins (7 month old infant and 33 month old child). 2. Congenital isolated mitral insufficiency in a 7 1/2 year old boy. 3. Combined mixed mitral valve malformations with a parachute valve-like mitral valve anomaly, combined with hypoplasia of the ascending and descending aortas, in a 6 1/2 year old girl. 4. Congenital mitral insufficiency with a parachute mitral valve, combined with supravalvular aortic stenosis and multiple peripheral stenoses of the pulmonary arteries in a 13 1/4 year old boy. 5. Insufficiency of the mitrally inverted tricuspid valve with so-called corrected transposition of the great vessels in a 6 year old boy and with Ebstein's anomaly in a 2 1/2 year old boy. 6. A second mitral ostium in the aortic mitral leaflet with a partial atrioventricular canal in a 6 3/4 year old girl with Ellis-van Creveld syndrome. 7. Bland-White-Garland syndrome with relative mitral insufficiency in a 5 month old and a 4 month old boy. Despite the recurrence of similar and comparable findings, each of our cases of congenital or early acquired noninfectious mitral valve malformation was formally different. n his was also true for the cases of congenital isolated mitral stenosis in twins. Therefore, surgical correction requires a unique procedure for each case. It is possible to reliably infer the degree of malfunction of the atrioventricular valve in a mitral position from the special pathology only by considering the clinical data. On the other hand, a detailed evaluation of congenital mitral valve malformations is possible only through direct inspection--either by the surgeon or through an autopsy--despite modern cardiodiagnostic methods. Typical secondary findings are also discussed--for instance, endocardial fibrosis of the left atrium and the configuration of the heart. The anatomical prerequisites for surgical reconstruction or replacement of the valve with a prosthesis are mentioned.
根据过去5年我们自己的手术和尸检材料中的以下实例，描述了二尖瓣可重建或仅通过假体矫正的先天性畸形的特殊病理学：1. 女性双胞胎（7个月大婴儿和33个月大儿童）中的先天性孤立性二尖瓣狭窄。2. 一名7岁半男孩中的先天性孤立性二尖瓣关闭不全。3. 一名6岁半女孩中合并有降落伞样二尖瓣异常的混合性二尖瓣畸形，同时合并升主动脉和降主动脉发育不全。4. 一名13岁零3个月男孩中先天性二尖瓣关闭不全合并降落伞样二尖瓣，同时合并瓣上主动脉狭窄和多处肺动脉外周狭窄。5. 一名6岁男孩中二尖瓣型三尖瓣反流合并所谓的大动脉转位矫正型，以及一名2岁半男孩中合并埃布斯坦畸形。6. 一名患有埃利斯-范克里夫德综合征的6岁零9个月女孩中，主动脉二尖瓣叶有第二个二尖瓣口并伴有部分房室通道。7. 一名5个月大男孩和一名4个月大男孩中伴有相对二尖瓣反流的布兰德-怀特-加兰综合征。尽管有相似和可比的发现反复出现，但我们每例先天性或早期获得性非感染性二尖瓣畸形在形式上都有所不同。双胞胎中的先天性孤立性二尖瓣狭窄病例也是如此。因此，手术矫正需要针对每个病例采用独特的手术方法。只有结合临床数据，才能从特殊病理学可靠推断二尖瓣位置的房室瓣功能障碍程度。另一方面，尽管有现代心脏诊断方法，但只有通过外科医生直接检查或尸检才能对先天性二尖瓣畸形进行详细评估。还讨论了典型的继发性发现，例如左心房的心内膜纤维化和心脏的形态。提到了瓣膜手术重建或用假体置换的解剖学前提条件。
