Schaff Hartzell V, Suri Rakesh M, Enriquez-Sarano Maurice
Divisions of Cardiovascular Surgery and Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Semin Thorac Cardiovasc Surg. 2007 Summer;19(2):97-102. doi: 10.1053/j.semtcvs.2007.04.001.
There has been great progress during the past decade in management of patients with mitral regurgitation. Doppler echocardiography allows accurate quantification of the degree of valve leakage and tracking of the effect of regurgitation on cardiac size and function. Natural history studies have clearly delineated the deleterious effects of severe, persistent mitral valve regurgitation including an increased risk of cardiac death as well as a predisposition to the development of congestive heart failure and atrial fibrillation. In virtually all of our analyses, short-term and long-term outcomes are improved in patients who have early surgical correction of severe mitral valve regurgitation. Moreover, there are clear benefits of mitral valve repair over valve replacement, including greater regression of left heart dimensions, normalization of left ventricular function, and superior long-term survival.
在过去十年中，二尖瓣反流患者的管理取得了巨大进展。多普勒超声心动图能够准确量化瓣膜反流程度，并追踪反流对心脏大小和功能的影响。自然史研究已明确界定了严重、持续性二尖瓣反流的有害影响，包括心脏死亡风险增加以及易患充血性心力衰竭和心房颤动。在我们几乎所有的分析中，早期接受严重二尖瓣反流手术矫正的患者，其短期和长期预后均得到改善。此外，二尖瓣修复术相对于瓣膜置换术具有明显优势，包括左心尺寸更大程度缩小、左心室功能恢复正常以及长期生存率更高。
