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[二尖瓣置换术后非典型部位左心室破裂:一例报告]

[Left ventricular rupture at an atypical place after mitral valve replacement: a case report].

作者信息

Shinohara M, Fujii N, Kouzu S, Yoshioka J, Akahane K, Tozuka N, Maruyama T

机构信息

Department of Cardiovascular Surgery, Nagano Red Cross Hospital, Japan.

出版信息

Kyobu Geka. 1993 Feb;46(2):187-9.

PMID:8437388
Abstract

Left ventricular rupture after mitral valve replacement (MVR) is a relatively rare, but a lethal complication. We report a case with this complication. The case was a 62-year-old woman with MSr, TR, and giant left atrium. She underwent MVR with SJM 29 mm, and TAP. During the operation, we found bleeding in the pericardial cavity, and confirmed left ventricular rupture. The place of the rupture was similar to Type I, but it was not posterior atrioventricular wall, but was lateral wall, left side of LAD. We thought that a manipulation during MVR was relevant to this event. Because, this place was opposite the anterolateral commissure of mitral valve to which the chordae tendineae and papillary muscles were adhered. It appeared that the annulus was injured at this point during the operative procedure.

摘要

二尖瓣置换术(MVR)后左心室破裂是一种相对罕见但致命的并发症。我们报告一例发生该并发症的病例。该病例为一名62岁女性,患有二尖瓣狭窄(MSr)、三尖瓣反流(TR)及巨大左心房。她接受了29毫米圣犹达机械瓣二尖瓣置换术及三尖瓣成形术(TAP)。手术过程中,我们发现心包腔内有出血,并确诊为左心室破裂。破裂部位类似于I型,但并非位于房室后壁,而是位于前降支左侧的侧壁。我们认为MVR术中操作与该事件有关。因为,该部位与二尖瓣前外侧连合相对,此处有腱索和乳头肌附着。手术过程中似乎在此处损伤了瓣环。

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