Ramakrishna Harish, Kohl Benjamin A, Jassar Arminder S, Augoustides John G T
Department of Cardiac Anesthesia, Mayo Clinic, Scottsdale, AZ.
Department of Anesthesiology and Critical Care, Cardiovascular and Thoracic Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
J Cardiothorac Vasc Anesth. 2014 Apr;28(2):417-22. doi: 10.1053/j.jvca.2013.11.003. Epub 2014 Feb 6.
Recent evidence has shown that moderate mitral regurgitation is common and clinically relevant in patients presenting for surgical and transcatheter aortic valve replacement for aortic stenosis. Prospective multicenter clinical trials are now indicated to resolve the clinical equipoise about whether or not mitral valve intervention also is indicated at the time of aortic valve intervention. Advances in three-dimensional transesophageal echocardiography, transcatheter mitral interventions, and surgical aortic valve replacement, including the advent of sutureless valves, likely will expand the therapeutic possibilities for moderate mitral regurgitation in the setting of aortic valve interventions for severe aortic stenosis.
近期证据表明，在因主动脉瓣狭窄接受外科手术和经导管主动脉瓣置换术的患者中，中度二尖瓣反流很常见且具有临床相关性。现在需要进行前瞻性多中心临床试验，以解决关于在主动脉瓣干预时是否也需要进行二尖瓣干预的临床平衡问题。三维经食管超声心动图、经导管二尖瓣干预以及外科主动脉瓣置换术的进展，包括无缝合瓣膜的出现，可能会扩大在严重主动脉瓣狭窄的主动脉瓣干预背景下治疗中度二尖瓣反流的可能性。
