Department of Cardiology, Eastern Heart Clinic, Prince of Wales Hospital, Sydney, Australia.
Heart Lung Circ. 2012 Dec;21(12):844-6. doi: 10.1016/j.hlc.2012.05.003. Epub 2012 Jun 21.
Ischaemic mitral regurgitation after myocardial infarction results from geometric changes in left ventricular shape and displacement of papillary muscles with resultant tethering and incomplete leaflet coaptation of mitral leaflets. Post mitral valve repair, both valve apparatus related factors such as persistent leaflet tethering and progressive left ventricular adverse remodelling and procedure related factors such as ring dehiscence are important causes of recurrent mitral regurgitation after initial undersized mitral ring annuloplasty. Three-dimensional echocardiography is a novel clinical tool that has the potential to provide additional anatomical and functional information regarding the mechanism of recurrent mitral regurgitation post mitral valve repair that is complementary to standard two dimensional transoesophageal echocardiography thus helping guide the most appropriate subsequent therapeutic intervention.
心肌梗死后缺血性二尖瓣反流是由于左心室形状的几何变化和乳头肌的移位，导致二尖瓣叶的牵张和不完全对合。二尖瓣修复术后，瓣叶相关因素（如持续的瓣叶牵张和进行性左心室不良重构）和手术相关因素（如环裂开）是初始小环二尖瓣成形术后复发性二尖瓣反流的重要原因。三维超声心动图是一种新的临床工具，它有可能提供关于二尖瓣修复术后复发性二尖瓣反流机制的额外解剖和功能信息，与标准二维经食管超声心动图互补，从而有助于指导最合适的后续治疗干预。
