Hayashibe Y, Nakagawa T, Yoshida T, Gotoh K, Maemura T, Konno S
Department of Cardiovascular Surgery, Metropolitan Hiroo General Hospital, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov;41(11):2224-8.
We reported a rare case of mitral valve aneurysm. The patient was a 67-year-old woman with regurgitation of mitral and aortic valve due to infective endocarditis. Preoperative two-dimensional echocardiogram revealed a aneurysmal change and prolapsing on anterior mitral leaflet. Left ventriculogram showed mitral regurgitation of Sellers IV. She underwent mitral valve replacement with 27 mm Carbo Medicus prosthesis successfully. There was a perforated valvular aneurysm (21 x 15 x 11 mm) and inflammatory cleft on anterior mitral leaflet at histopathological findings. The pathogenesis of mitral valve aneurysm was generally infective endocarditis and rarely congenital anomaly, syphylis, Aortitis syndrome, or Marfan syndrome. Mitral valve replacement was a procedure of choice for mitral valve aneurysm, which is especially large, perforated and severely inflammatory one.
我们报告了一例罕见的二尖瓣动脉瘤病例。患者为一名67岁女性,因感染性心内膜炎导致二尖瓣和主动脉瓣反流。术前二维超声心动图显示二尖瓣前叶有动脉瘤样改变和脱垂。左心室造影显示 Sellers IV 级二尖瓣反流。她成功接受了二尖瓣置换术,使用的是27毫米 Carbomedics 人工瓣膜。组织病理学检查发现二尖瓣前叶有一个穿孔的瓣膜动脉瘤(21×15×11毫米)和炎性裂隙。二尖瓣动脉瘤的发病机制通常是感染性心内膜炎,很少是先天性异常、梅毒、主动脉炎综合征或马凡综合征。二尖瓣置换术是二尖瓣动脉瘤的首选治疗方法,尤其是对于较大、穿孔且炎症严重的动脉瘤。