Suda H, Itoh T, Natsuaki M, Ohteki H, Ohtsubo S, Sakurai J
Department of Cardiovascular Surgery, Koga Hospital, Kurume, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Mar;41(3):513-8.
We report a case of mitral regurgitation caused by a total rupture of the posterior papillary muscle that had occurred after acute myocardial infarction. A 72-year-old woman was transferred to our hospital for cardiogenic shock. Echocardiogram revealed massive mitral regurgitation and prolapse of posterior mitral leaflet presumably due to a rupture of a papillary muscle. Cardiac catheterization demonstrated a total occlusion in the segment 2 of the right coronary artery. She had developed progressively increasing heart failure even though the patient had received a successful PTCA for a total occlusion of the right coronary artery. She underwent an emergency mitral valve replacement with preservation of the posterior leaflet using a SJM prosthetic valve. Intraoperative findings were confirmative of total rupture of the posterior papillary muscle. A postoperative course was uneventful. This case is the seventh case which has been reported as the successful operation of a total rupture of the papillary muscle in Japan.
我们报告一例急性心肌梗死后发生后乳头肌完全断裂导致二尖瓣反流的病例。一名72岁女性因心源性休克转入我院。超声心动图显示大量二尖瓣反流及二尖瓣后叶脱垂，推测是乳头肌破裂所致。心导管检查显示右冠状动脉第2节段完全闭塞。尽管该患者右冠状动脉完全闭塞已成功接受经皮冠状动脉腔内血管成形术（PTCA），但其心力衰竭仍逐渐加重。她接受了紧急二尖瓣置换术，使用圣犹达医疗用品公司（SJM）人工瓣膜保留后叶。术中发现证实后乳头肌完全断裂。术后病程平稳。该病例是日本报道的乳头肌完全断裂成功手术的第七例。
