中国人心脏房室瓣的类型调查(100例)

THE MODE OF THE ATRIO-VENTRICULAR VALVE OF THE HEART IN CHINESE

本报告调查了100例成年中国人的死后固定的心脏标本。右房室瓣以四个主瓣为最常见,占80%。三个主瓣的占19%,只有两个主瓣的占1%。除主瓣外,在右心室内侧壁与前、后壁之间有时存在小的分裂瓣,可以称它们为“副瓣”。前副瓣出现率为31%,后副瓣为27%。若以主副瓣总数计算,则右房室瓣以四个瓣(42%)和五个瓣(36%)为最常见,其次为三个瓣(13%),六个瓣(8%)和二个瓣(1%)。左房室瓣由二个主瓣构成。但后瓣往往极度分裂,以致后瓣可由一个大瓣和一至四个小瓣所组成;仅有一个大瓣而没有分裂瓣的例子只占12%。我们将二尖瓣的后瓣归纳为三种类型:(1)后瓣的中部发育较好(48%);(2)后瓣的前外部发育较好(35%);(3)后瓣的后内部发育较好(17%)。前瓣分裂为二部的极少,只见一例(1%)。在调查同时,测量了各个瓣膜的高度及相邻瓣膜间的连接缘的高度。并讨论了区别主、副瓣的原则。

The atrio-ventricular valves of the normal heart of 100 Chinese adult cadavers were studied.The right atrio-ventricular(tricuspid)valve was found to be composed of four main cusps in 80%of the cases,three main cusps in 19%,and two main cusps in 1%.In certain cases,small additional intermediate cusps had been found.They were derived from the main cusps and situated in the angles between the medial and anterior wall,or between the medial and posterior wall of the right ventricle.These may be called“cuspi accessoria”.The anterior accessory cusp was present in 31%and the posterior accessory cusp in 27%of our preparations.If the total number of the main and acces-sory cusps of the right a—v valve was considered,four cusps occurred in 42%,five in 36%,three in 13%,six in 8%and two in 1%.The left atrio-ventricular(mitral)valve consisted of two main cusps.But frequent-ly there were conspicuous ruptures on the posterior cusp in our specimens,with the ex-ception of twelve cases(12%).Thus,the posterior cusp may be consisted of one greater leaflet and one to four smaller leaflets.Based on this character,the posterior cusp of the left a—v valve may be grouped into three types:(1)the middle portion of the posterior cusp was well developed in 48%;(2)the antero-lateral portion was well developed in 35%;and(3)the postero-medial portion was well developed in 17%.The anterior cusp of the left a—v valve separated into two equal parts had been found in one case(1%).The height of the cusps and of the commissural margins,where the neighboring cusps were joined,had been measured.Discussions have been made on the principles of the differentiation between the main cusp and the accessory cusp.