二尖瓣腱索断裂七例报告

作者报告了7例二尖瓣腱索断裂并发关闭不全的外科治疗。对其病因病理、临床诊断、外科手术指征和术式选择做了讨论,其中5例继发于风湿性心脏病,2例原因不明,临床表现有顽固性心衰,部分病例心脏听诊有海鸥鸣杂音。各项诊断检查中以超声心动图较可靠。本组对5例多条腱索离断,位于瓣膜中部或伴有瓣膜穿孔、撕裂者行瓣膜置换;对2例1～2条腱索离断,靠近交界处者行腱索修复和/或环部或形术。2例手术死亡,5例良好。

Ruptured chordae tendinae of the mitral valve

Seven cases of ruptured chordae tendinae with severe mitral regurgitation were presented in this article.The aetiology, pathology, clinical diagnosis, surgical indications, and surgical technology of ruptured chordae tendinae were discussed. Primary rupture ( spontaneous ) was considered in 2 cases, while secondary rupture, caused by chronic rheumatic valvular disease, in 5. Echocardiography is one of the most diagnostic measures.The autaors suggest that in case of multiple ruptured chordae tendinae with valvular tear or perforation, valve replacement is indicated. If merely one or two chordae tend- inae are ruptured, surgical repair and/or annuloplasty are required. Valve replacement was performed on five patients, and annuloplasty was performed on the other two cases. One of the latter two cases had the ruptured chordae tendi- nae been repaired. Two patients died of heart failure postoperatively, the remainder were doing well.