Apostolakis Efstratios E, Baikoussis Nikolaos G
Cardio-Thoracic Surgery Department, School of Medicine, University Hospital of Patras, Patras, Greece.
J Cardiothorac Surg. 2009 Jul 15;4:34. doi: 10.1186/1749-8090-4-34.
Mitral valve regurgitation is a relatively common and important heart valve lesion in clinical practice and adequate assessment is fundamental to decision on management, repair or replacement. Disease localised to the posterior mitral valve leaflet or focal involvement of the anterior mitral valve leaflet is most amenable to mitral valve repair, whereas patients with extensive involvement of the anterior leaflet or incomplete closure of the valve are more suitable for valve replacement. Echocardiography is the recognized investigation of choice for heart valve disease evaluation and assessment. However, the technique is depended on operator experience and on patient's hemodynamic profile, and may not always give optimal diagnostic views of mitral valve dysfunction. Cardiac catheterization is related to common complications of an interventional procedure and needs a hemodynamic laboratory. Cardiac magnetic resonance (MRI) seems to be a useful tool which gives details about mitral valve anatomy, precise point of valve damage, as well as the quantity of regurgitation. Finally, despite of its higher cost, cardiac MRI using cine images with optimized spatial and temporal resolution can also resolve mitral valve leaflet structural motion, and can reliably estimate the grade of regurgitation.
二尖瓣反流是临床实践中一种相对常见且重要的心脏瓣膜病变，充分评估对于决定治疗、修复或置换至关重要。局限于二尖瓣后叶的疾病或二尖瓣前叶的局灶性受累最适合二尖瓣修复，而前叶广泛受累或瓣膜关闭不全的患者更适合瓣膜置换。超声心动图是公认的用于评估心脏瓣膜疾病的首选检查方法。然而，该技术依赖于操作者的经验和患者的血流动力学状况，并且可能并不总是能提供二尖瓣功能障碍的最佳诊断图像。心导管检查与介入操作的常见并发症相关，并且需要血流动力学实验室。心脏磁共振成像（MRI）似乎是一种有用的工具，它能提供二尖瓣解剖结构、瓣膜损伤的确切部位以及反流程度的详细信息。最后，尽管心脏MRI成本较高，但使用具有优化空间和时间分辨率的电影图像也可以解析二尖瓣叶的结构运动，并能可靠地估计反流程度。
