Terai H, Okada Y, Hamaya H, Sugiki K, Ohno T
Department of Cardiovascular Surgery, Hokkaido Ohno Hospital, Sapporo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1101-4.
Forty three year-old male who had cough and easy fatigability since three weeks prior to admission was diagnosed to have acute pulmonary edema with severe mitral regurgitation caused by active infective endocarditis. Transesophageal echocardiograms under the endotracheal intubation for controlled respiration suggested rupture of the posterior papillary muscle of the mitral valve and the emergency surgical treatment was performed. Intraoperatively the total rupture of the posterior papillary muscle was confirmed and mitral valve replacement was carried out with a SJM prosthetic valve. Histological examination of the ruptured papillary muscle revealed hemorrhage, muscle necrosis and small cell infiltration suggesting the presence of active inflammation with bacteria on it. Staphylococcus epidermidis was demonstrated by the bacteriological studies of the ruptured papillary muscle.
一名43岁男性，入院前三周开始出现咳嗽和易疲劳症状，被诊断为急性肺水肿，由活动性感染性心内膜炎引起严重二尖瓣反流。在气管插管控制呼吸下行经食管超声心动图检查提示二尖瓣后乳头肌破裂，遂行急诊手术治疗。术中证实二尖瓣后乳头肌完全破裂，用圣犹达（SJM）人工瓣膜进行二尖瓣置换。对破裂乳头肌的组织学检查显示有出血、肌肉坏死和小细胞浸润，提示存在伴有细菌的活动性炎症。对破裂乳头肌的细菌学研究证实为表皮葡萄球菌。
