Capoulade Romain, Piriou Nicolas, Serfaty Jean-Michel, Le Tourneau Thierry
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Institut du Thorax, CHU Nantes, Nantes University, Nantes, France.
J Thorac Dis. 2017 Jun;9(Suppl 7):S640-S660. doi: 10.21037/jtd.2017.06.99.
Secondary mitral regurgitation (MR) is frequent valvular heart disease and conveys worse prognostic. Therapeutic surgical or percutaneous options are available in the context of severe symptomatic secondary MR, but the best approach to treat these patients remains unclear, given the lack of clear clinical evidence of benefit. A comprehensive evaluation of the mitral valve apparatus and the left ventricle (LV) has the ability to clearly define and characterize the disease, and thus determine the best option for the patient to improve its clinical outcomes, as well as quality of life and symptoms. The current report reviews the mitral valve (MV) anatomy, the underlying mechanisms associated with secondary MR, the related therapeutic options available, and finally the usefulness of a multimodality imaging approach for the planning of surgical or percutaneous mitral valve intervention.
继发性二尖瓣反流(MR)是常见的瓣膜性心脏病,预后较差。对于症状严重的继发性MR患者,有手术或经皮治疗方案可供选择,但鉴于缺乏明确的临床获益证据,治疗这些患者的最佳方法仍不明确。对二尖瓣装置和左心室(LV)进行全面评估能够清晰地界定和描述该疾病,从而为患者确定最佳治疗方案,以改善其临床结局、生活质量和症状。本报告回顾了二尖瓣(MV)的解剖结构、与继发性MR相关的潜在机制、现有的相关治疗方案,最后阐述了多模态成像方法在外科或经皮二尖瓣介入治疗规划中的作用。