Akasaka K, Kawashima E, Yamazaki S, Aizawa Y, Shiokoshi T, Ishii Y, Kikuchi K
First Department of Internal Medicine, Asahikawa Medical College.
J Cardiol. 1996 Dec;28(6):349-54.
A 71-year old man presented with partial rupture progressing to complete rupture of the left ventricular anterior papillary muscle after acute anterolateral myocardial infarction. The progressive rupture was demonstrated by transthoracic and transesophageal echocardiography. Transthoracic echocardiography showed exaggerated systolic prolapse of the anterior mitral leaflet with grade III mitral regurgitation and partial disruption of the anterolateral papillary muscle, but transesophageal echocardiography during surgery disclosed the progression of the partial rupture to complete rupture. The flail anterior mitral leaflet with severe mitral regurgitation and the head of the ruptured papillary muscle into the left atrium in systole were confirmed. The patient was treated by coronary artery bypass grafting and mitral valve prosthesis using a St. Jude Medical valve with good outcome.
一名71岁男性在急性前侧壁心肌梗死后出现左心室前乳头肌部分破裂并进展为完全破裂。经胸和经食管超声心动图显示了这种渐进性破裂。经胸超声心动图显示二尖瓣前叶收缩期脱垂加重,伴有III级二尖瓣反流和前外侧乳头肌部分断裂,但手术期间的经食管超声心动图显示部分破裂进展为完全破裂。证实了二尖瓣前叶连枷样运动伴严重二尖瓣反流以及破裂乳头肌头部在收缩期进入左心房。该患者接受了冠状动脉旁路移植术,并使用圣犹达医疗瓣膜进行二尖瓣置换,效果良好。