古川 重治, 中村 一彦, 屋宮 和哉, 田渕 博己, 真田 純一, 南 幸弘, 宮原 健吉, 橋本 修治

Shigeharu FURUKAWA, Kazuhiko NAKAMURA, Kazuya OKUMIYA, Hiromi TABUCHI, Junichi SANADA, Yukihiro MINAMI, Kenkichi MIYAHARA, Shuji HASHIMOTO

鹿児島大学医学部第二内科

The 2nd Dep. of Intern. Med, School of Med, Kagoshima Univ, Kagoshima 890

キーワード : Two-dimensional echocardiography, Rupture of ch ordae tendieae of mitral valve, Prolongation of chordae tendineae of mitral valve

Two-dimensional echocardiography was performed in 7 patients with ruptured chordae tendineae of the mitral valve, and in 2 patients with prolongated chordae tendineae of the mitral valve proved by open heart surgery. 　In cases of ruptured chordae tendineae, we have found; 　
1) Systolic abnormal motion in 8 affected leaflets of 7 patients, 　
­a) Systolic overshooting in 2 leaflets, 　
­b) Systolic prolapse in 6 leaflets, 　
2) Diastolic prolapse in 6 leaflets, 　
­3) Delayed opening in 2 leaflets, 　
­4) Chaotic motion of ruptured chordae tendineae in 4 leaflets. 　
Systolic overshooting of an affected leaflet and chaotic motion of ruptured chordae tendineae were considered to be characteristic findings of mitral regurgitation resulted from ruptured chordae tendineae. Systolic prolapse accompanied with diastolic prolapse was a supportive finding to diagnose mitral regurgitation resulted from ruptured chordae tendineae. However, mitral regurgitation resulted from ruptured chordae tendineae could not be distinguished from mitral regurgitation resulted from prolongated chordae tendineae by these findings. 　
It may be possible to diagnose mitral regurgitation resulted from ruptured chordae tendineae in severe cases of ruptured chordae tendineae, while it may be difficult in mild cases.