Chandrashekhar Y, Westaby Stephen, Narula Jagat
Veterans Affairs Medical Center and University of Minnesota, Minneapolis, MN 55417, USA.
Lancet. 2009 Oct 10;374(9697):1271-83. doi: 10.1016/S0140-6736(09)60994-6. Epub 2009 Sep 9.
Mitral stenosis is a common disease that causes substantial morbidity worldwide. The disease is most prevalent in developing countries, but is increasingly being identified in an atypical form in developed countries. All treatments that increase valve area improve morbidity. Mortality improves with surgery; the benefit of percutaneous balloon valvuloplasty to mortality might be similar to that of surgery but needs further study. Percutaneous balloon valvuloplasty is the treatment of choice for patients in whom treatment is indicated, except for those with suboptimum valve morphology, and even these patients are sometimes treated with this procedure if surgery is not feasible or if surgical risk is prohibitive. We review the pathology, diagnosis, and treatment options for patients with mitral stenosis.
二尖瓣狭窄是一种在全球范围内导致大量发病的常见疾病。该疾病在发展中国家最为普遍，但在发达国家也越来越多地以非典型形式被发现。所有增加瓣膜面积的治疗方法都能改善病情。手术可降低死亡率；经皮球囊瓣膜成形术对死亡率的益处可能与手术相似，但仍需进一步研究。经皮球囊瓣膜成形术是有治疗指征患者的首选治疗方法，瓣膜形态欠佳的患者除外，不过如果手术不可行或手术风险过高，即使是这些患者有时也会接受该手术。我们对二尖瓣狭窄患者的病理、诊断和治疗选择进行综述。
