Severe Mitral Regurgitation Secondary to Ruptured Chordae Tendineae.
نویسندگان
چکیده
RUPTURE of the chordae tendineae is an uncommon event that may lead to sudden mitral regurgitation, the severity of which generally depends on the number and location of the chordae involved.1 It has been reported to occur with active bacterial or rheumatic endocarditis, in association with healed rheumatic valvulitis, following healed bacterial endocarditis or trauma, or "spontaneously" in hearts without pre-existing mitral valve disease.1-9 In contrast to patients with the usual form of rheumatic mitral regurgitation, those with ruptured chordae tendineae usually die within a year, although a few cases of prolonged survival have been reported.5 10 With the availability of satisfactory surgical technics for the treatment of mitral regurgitation, accurate clinical assessment of the lesion has obvious therapeutic implications. 16-6 The purpose of this communication is to report our experience in 15 patients with severe mitral regurgitation due to ruptured chordae tendineae. Pertinent features in the clinical evaluation that aid in the diagnosis are discussed. Particular emphasis is placed on the eight patients undergoing open-heart surgery, six of whom were studied by cardiac catheterization preoperatively. Three of these eight patients are living, and two show marked improvement 5 months and 3 years after surgery. Postoperative study of the third patient by cardiac catheterization combined with angiography has shown marked improvement in cardiac function and virtual disappearance of mitral regurgitation.
منابع مشابه
Motion of the interatrial septum in acute mitral regurgitation. Clinical and experimental echocardiographic studies.
The interatrial septal echocardiograms from 15 patients with acute mitral regurgitation due to ruptured chordae tendineae were compared with those from 14 normal subjects. On the cross-sectional echocardiogram, the interatrial septal configuration in patients with chordal rupture showed a characteristic pattern in which the interatrial septum (IAS) was flat or slightly convex toward the left at...
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Hemodynamics in ruptured chordae tendineae and chronic rheumatic mitral regurgitation.
Twenty-five patients with proven ruptured mitral chordae tendineae and 25 patients with chronic rheumatic mitral regurgitation were studied with quantitative biplane left-heart angiocardiography. Compared to the rheumatic patients, the ruptured chordae group had strikingly smaller left atrial maximum volume (mean: 119 + 47 vs 267 + 131 mI/M2 mean) and less compliant left atrium (mean: 1.61 1.52...
متن کاملEchocardiographic Diagnosis of Mitral Regurgitation due to Ruptured
The echocardiographic findings from six patients with ruptured chordae tendineae from the posterial mitral valve leaflet and three with ruptured chordae from the anterior leaflet are reported; in all cases the diagnosis was later proven by openheart surgery. The constellation of echocardiographic findings suggesting iruptured chordae tendineae to the posterior leaflet are: (1) The appearance of...
متن کاملEchocardiographic diagnosis of mitral regurgitation due to ruptured chordae tendineae.
The echocardiographic findings from six patients with ruptured chordae tendineae from the posterial mitral valve leaflet and three with ruptured chordae from the anterior leaflet are reported; in all cases the diagnosis was later proven by openheart surgery. The constellation of echocardiographic findings suggesting iruptured chordae tendineae to the posterior leaflet are: (1) The appearance of...
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ورودعنوان ژورنال:
- Circulation
دوره 31 شماره
صفحات -
تاریخ انتشار 1965