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[一例因外伤性三尖瓣乳头肌撕裂致单纯三尖瓣反流的成功瓣膜修复病例]

[A successful valve repair case of isolated tricuspid regurgitation due to traumatic lacerated papillary muscle of the tricuspid valve].

作者信息

Sakuragawa H, Koyama N, Watanabe Y, Yoshihara K, Kawamura K, Yamazaki S

机构信息

Department of Thoracic and Cardio-Vascular Surgery, Toho University School of Medicine, Tokyo, Japan.

出版信息

Jpn J Thorac Cardiovasc Surg. 1998 Jan;46(1):91-5. doi: 10.1007/BF03217729.

Abstract

A case of tricuspid valve regurgitation due to a non-penetrating chest trauma was presented. This case involves a 20-year-old man, who was admitted to a nearby hospital because of rib fracture, mandibular fracture, and hemorrhage of the left hemopneumothorax, caused by a traffic accident. Palpitation and chest discomfort were observed at admission time, but there was no follow-up. Tricuspid regurgitation was pointed out during surgery for the mandibular fracture, and he continued follow up treatment at an outpatient clinic. However his palpitation and chest discomfort worsened, and he was admitted to our department 8 month after injury. During surgery to repair the tricuspid valve, a papillary muscle rupture, valve cusp laceration, and anulus dilatation were found. We performed a papillary muscle repair (chorda tendineae reconstruction), valve cusp suture, and annuloplasty. Absence of the left pericardium was observed during the operation. We reported valve repair of traumatic tricuspid regurgitation which with papillary muscle rupture. Due to its rarity and the fact that there has been no reported cases of papillary muscle repair for traumatic tricuspid regurgitation in Japan, we used researched information on the subject.

摘要

本文报告一例因非穿透性胸部创伤导致三尖瓣反流的病例。该病例为一名20岁男性,因交通事故导致肋骨骨折、下颌骨骨折及左侧血气胸出血,被送往附近医院。入院时发现有心悸和胸部不适,但未进行后续检查。在下颌骨骨折手术期间发现三尖瓣反流,随后他在门诊继续接受随访治疗。然而,他的心悸和胸部不适症状加重,受伤8个月后入住我科。在修复三尖瓣的手术中,发现乳头肌破裂、瓣膜尖撕裂和瓣环扩张。我们进行了乳头肌修复(腱索重建)、瓣膜尖缝合和瓣环成形术。手术过程中发现左侧心包缺失。我们报告了伴有乳头肌破裂的创伤性三尖瓣反流的瓣膜修复情况。由于其罕见性,且在日本尚无创伤性三尖瓣反流乳头肌修复的报道病例,我们查阅了该主题的研究资料。

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