Masson Jean-Bernard, Forcillo Jessica
Division of Cardiology and Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM) Montreal, Quebec, Canada.
Centre de Recherche du Centre Hospitalier de l'Université de Montréal Montreal, Quebec, Canada.
US Cardiol. 2021 Nov 29;15:e26. doi: 10.15420/usc.2021.17. eCollection 2021.
Significant mitral regurgitation (MR), frequently seen in the presence of severe aortic stenosis (AS), results in an association that negatively affects prognosis and imposes particular challenges for both the assessment of the severity of valvular lesions and decisions regarding treatment allocation. This article reviews the available literature with regards to the assessment of MR and AS in the presence of both; surgical management and results in patients with concomitant AS and MR; the effect of MR on outcomes in patients undergoing transcatheter aortic valve replacement; the effect of transcatheter aortic valve replacement on MR severity; and percutaneous treatment for MR after transcatheter aortic valve implantation. The authors aim to provide assistance in the decision-making process to treat patients with either a higher-risk double-valve procedure or a simpler, but perhaps incomplete, single-valve option.
重度二尖瓣反流（MR）在严重主动脉瓣狭窄（AS）患者中较为常见，这种关联会对预后产生负面影响，并且在评估瓣膜病变严重程度以及决定治疗方案时带来特殊挑战。本文回顾了关于同时存在MR和AS时的评估、外科治疗管理及合并AS和MR患者的治疗结果、MR对经导管主动脉瓣置换术患者预后的影响、经导管主动脉瓣置换术对MR严重程度的影响以及经导管主动脉瓣植入术后MR的经皮治疗等方面的现有文献。作者旨在为治疗高风险双瓣膜手术患者或更简单但可能不完整的单瓣膜手术患者的决策过程提供帮助。
