Sugimoto T, Shimanuki T, Minowa T, Uchino H, Nakamura C
Department of Surgery, Yamagata Prefectural Nihonkai Hospital, Sakata, Japan.
Kyobu Geka. 1998 Dec;51(13):1120-2.
We reported a case with severe mitral regurgitation caused by total rupture of the posterior papillary muscle two days after aortic valve replacement. A 62-year-old man was transferred to our hospital with high fever and dyspnea with severe aortic regurgitation caused by infective endocarditis. The left heart failure occurred suddenly two days after the initial operation. Echocardiogram revealed massive mitral regurgitation and rupture of the posterior papillary muscle. He underwent emergent mitral valve replacement. Histological examination of the papillary muscle showed typical ischemic necrosis without inflammation. The postoperative course was uneventful. We suggested the papillary muscle rupture in this case may be due to coronary artery emboli occurred in association with infective endocarditis.
我们报告了一例主动脉瓣置换术后两天因后乳头肌完全断裂导致严重二尖瓣反流的病例。一名62岁男性因感染性心内膜炎导致严重主动脉反流伴高热和呼吸困难被转至我院。初次手术后两天突然发生左心衰竭。超声心动图显示大量二尖瓣反流和后乳头肌断裂。他接受了急诊二尖瓣置换术。乳头肌组织学检查显示典型的缺血性坏死，无炎症。术后过程顺利。我们认为该病例中乳头肌破裂可能是由于与感染性心内膜炎相关的冠状动脉栓塞所致。
