瓦氏窦破裂入室间隔内

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　　　　　　　　　　　瓦氏窦破裂入室间隔内

女性，27岁，既往健康，以在一次普通感冒症状发生后，发生呼吸困难3个月入院。临床诊断充血心力衰竭，放射学检查也证实以上诊断。

经胸多普勒超声检查证实瓦氏窦破裂进入室间隔内（图1、2），并观察到在舒张早期有主动脉的血流重度返流到室间隔内的与心室无交通的假腔内，左室腔中度扩张并引起前乳头肌移位而发生了重度二尖瓣的返流。

经食管超声心动图显示破口位置和返流进入到假腔内（图3：a和b）。这些征象在mri检查得到证实（图4）。

予内科治疗使病人的病情得到稳定后，行外科手术修补。

手术后的经食管超声心动图检查，发现到假腔内的反流消失，二尖瓣返流减轻了（尽管仍为中度的二尖瓣返流），动脉瘤囊明显的减小了。
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英文如下：

sinus of valsalva rupture with dissection into the interventricular septum
a 27-year-old previously healthy woman presented with a 3-month-long history of dyspnea after a nonspecific flu-like illness. congestive heart failure was diagnosed clinically and confirmed radiographically. a transthoracic echocardiogram demonstrated rupture of the sinus of valsalva with dissection into the interventricular septum (figures 1 and 2). severe early diastolic regurgitation into the false, noncommunicating cavity was observed within the septum, as well as moderate left ventricular chamber dilatation, distortion of the anteromedial papillary muscle, and consequent severe mitral regurgitation. a transesophageal echocardiogram showed the site of the rupture with flow into the false cavity (figure 3, a and b). these findings were confirmed on magnetic resonance imaging (mri； figure 4). the patient was stabilized medically and underwent surgical repair. the postoperative transesophageal echocardiogram demonstrated elimination of the regurgitation into the false cavity and decreased mitral regurgitation (although still moderate) and a much smaller aneurysmal sac.
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　　　　　　　　　　　　　　　　　　　　　　　　　图3和4：

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