Yuan Shi-Min
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan 23;28(1):219-226. doi: 10.5606/tgkdc.dergisi.2020.18041. eCollection 2020 Jan.
This review aims to discuss morphology and surgical management of parachute mitral valve.
A total of 62 articles in the English language with 330 parachute mitral valve patients were retrieved from the PubMed, HighWire Press, and Cochrane Library databases using specific MeSH terms and keywords between January 2000 and December 2018. In these articles, morphology of parachute mitral valve and surgical treatment options were investigated.
A non-syndromic parachute mitral valve was present in 287 patients (87.0%) and a syndromic parachute mitral valve was present in 43 patients (13.0%). A higher number of patients with a non-syndromic parachute mitral valve presented with congestive heart failure compared to syndromic ones. The patients with a non-syndromic parachute mitral valve often had mitral regurgitation, while syndromic parachute mitral valve patients often had mitral stenosis.
Parachute mitral valves are usually not an isolated lesion and are often characterized by a constellation of pathological changes of the mitral valve leaflets, annulus, commissures, subvalvular apparatus, and supravalvular mitral ring. Therefore, the majority of the patients need one or more surgical operations. The incidence of adverse events such as reintervention, postoperative complete heart block, and mortality is high in these patients.
本综述旨在探讨降落伞样二尖瓣的形态及外科治疗。
2000年1月至2018年12月期间，使用特定的医学主题词和关键词，从PubMed、HighWire Press和Cochrane图书馆数据库中检索了62篇英文文章，共纳入330例降落伞样二尖瓣患者。在这些文章中，对降落伞样二尖瓣的形态及外科治疗选择进行了研究。
287例患者（87.0%）为非综合征性降落伞样二尖瓣，43例患者（13.0%）为综合征性降落伞样二尖瓣。与综合征性患者相比，非综合征性降落伞样二尖瓣患者出现充血性心力衰竭的人数更多。非综合征性降落伞样二尖瓣患者常伴有二尖瓣反流，而综合征性降落伞样二尖瓣患者常伴有二尖瓣狭窄。
降落伞样二尖瓣通常不是孤立的病变，常表现为二尖瓣叶、瓣环、瓣交界、瓣下装置及二尖瓣上环形结构的一系列病理改变。因此，大多数患者需要进行一次或多次外科手术。这些患者再次干预、术后完全性心脏传导阻滞及死亡等不良事件的发生率较高。
