Hayek Emil, Gring Christian N, Griffin Brian P
Akron General Hospital, Akron, OH, USA.
Lancet. 2005;365(9458):507-18. doi: 10.1016/S0140-6736(05)17869-6.
Mitral valve prolapse is a common valvular abnormality that is the most common cause of severe non-ischaemic mitral regurgitation in the USA. The overall prognosis of patients with mitral valve prolapse is excellent, but a small subset will develop serious complications, including infective endocarditis, sudden cardiac death, and severe mitral regurgitation. We present a comprehensive review of mitral valve prolapse, examining normal mitral anatomy, the clinical and echocardiographic features of mitral valve prolapse, and the pathophysiology and genetics of the disorder. We discuss the contemporary management of both asymptomatic and symptomatic prolapse, with particular attention to the timing and technique of surgical repair. We conclude that echocardiography is the method of choice for diagnosing mitral valve prolapse, that clinical and echocardiographic features can predict which patients with prolapse are at highest risk for complications, and that mitral valve repair is the treatment of choice for symptomatic prolapse.
二尖瓣脱垂是一种常见的瓣膜异常,是美国严重非缺血性二尖瓣反流的最常见原因。二尖瓣脱垂患者的总体预后良好,但一小部分患者会出现严重并发症,包括感染性心内膜炎、心源性猝死和严重二尖瓣反流。我们对二尖瓣脱垂进行了全面综述,研究了二尖瓣的正常解剖结构、二尖瓣脱垂的临床和超声心动图特征以及该疾病的病理生理学和遗传学。我们讨论了无症状和有症状脱垂的当代管理方法,特别关注手术修复的时机和技术。我们得出结论,超声心动图是诊断二尖瓣脱垂的首选方法,临床和超声心动图特征可以预测哪些脱垂患者发生并发症的风险最高,二尖瓣修复是有症状脱垂的首选治疗方法。