Senior Associate Consultant, Department of Cardiovascular Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Heart Fail Clin. 2018 Oct;14(4):585-600. doi: 10.1016/j.hfc.2018.06.006. Epub 2018 Aug 18.
Mitral valve diseases are common causes of congestive heart failure. Chronic primary and secondary (functional) mitral valve regurgitation are the most common reasons. Valve repair for primary mitral regurgitation cures mitral valve disease, whereas in functional regurgitation, mitral valve repair is associated with high failure rates secondary to persistent/progressive ventricular dysfunction and remodeling. Most patients are managed with strict adherence to the valve guidelines. Mitral valve replacement has an increased role in management of functional mitral regurgitation. Surgery for mitral valve disease is indicated in symptomatic patients with severe valve disease and in asymptotic before irreversible ventricular damage occurs.
二尖瓣疾病是充血性心力衰竭的常见原因。慢性原发性和继发性（功能性）二尖瓣反流是最常见的原因。原发性二尖瓣反流的瓣膜修复可以治愈二尖瓣疾病，而在功能性反流中，由于持续/进行性心室功能障碍和重塑，二尖瓣修复的失败率很高。大多数患者都严格遵循瓣膜指南进行管理。二尖瓣置换在功能性二尖瓣反流的治疗中具有更大的作用。对于有严重瓣膜疾病且无症状的患者，以及在不可逆心室损伤发生之前无症状的患者，二尖瓣疾病的手术治疗是指征。
