Complete Resolution of Diastolic Mitral Regurgitation in Chronic, but Not Acute Aortic Regurgitation after Aortic Valve Replacement - A Transesophageal Echocardiography Study

舒張期二尖瓣閉鎖不全在慢性而非急性主動脈閉鎖不全病人行主動脈瓣置換術後完全消失－經食道心臟超音波研究之病例報告

王正宏(Cheng-Haung Wang) ； 詹國泰(Kuo-Tai Jan) ； 劉彥青(Yen-Chin Liu) ； 何長權(Chang-Chuan He) ； 周文英(Wen-Ying Chou) ； 李明謙(Ming-Chien Lee) ； 劉康(Kang Liu)

《Acta Anaesthesiologica Sinica》 34卷1期 (1996/03) Pp. 37-41

https://doi.org/10.6955/AAS.199603.0037

摘要

A 65-year-old male was admitted with progressive dyspnea on exertion. Severe aortic regurgitation (AR) had been disclosed by transthoracic echocardiography 10 mon previously. Aortic valve replacement was proposed and intraoperative transesophageal echocardiography on color Doppler imaging revealed severe aortic regurgitation, moderate global hypokinesis of the left ventricle and mild-to-moderate diastolic mitral regurgitation. The regurgitant jet was seen to pass through the posterior mitral leaflet in a direction toward the center of left atrium. Mitral valve perforation was suspected. But mitral valve was found to be intact after a thorough exploration. Surgery proceeded uneventfully and diastolic mitral regurgitation was resolved completely after the aortic valve was successfully replaced. Diastolic mitral regurgitation has been reported to be closely related to acute AR, but the picture differs somewhat from the present example. The possible cause for this disease presentation is to be further investigated.

關鍵字

Heart valve disease: mitral valve insufficiency ； Echocardiography: transesophageal

並列摘要

一位六十五歲男性因漸進性呼吸困難而入院，其病史可追溯到十個月前由心臟超音波診斷為重度主動脈閉鎖不全及左心室舒張功能受損。在行主動脈瓣置換術時，經食道心臟超音波併彩色杜卜勒影像顯示重度主動脈閉鎖不全、中度左心室整體運動減弱、和輕度至中度心舒張期二尖瓣閉鎖不全，其逆流噴射流經二尖瓣後葉而指向左心房中央，被一度懷疑有二尖瓣穿孔。但手術中仔細檢查後，發現二尖瓣並無異常。同時手術完成後其心舒張期二尖瓣閉鎖不全完全消失，其後追蹤並無再復發的現象。文獻報告指出心舒張期二尖瓣閉鎖不全與急性主動脈閉鎖不全、心房顫動、房室傳導阻斷等關係極為密切，而本病例為慢性主動脈閉鎖不全之案例，其可能造成心舒張期二尖瓣閉鎖不全的原因仍須進一步探討。

並列關鍵字

心臟瓣膜疾病：二尖瓣閉鎖不全 ； 心臟超音波：經食道