Hůla J
I. interní klinika FN, Plzen.
Vnitr Lek. 1995 Dec;41(12):842-5.
Mitral stenosis, being a progressive disease, remains even at present an important specialized diagnostic field of cardiology which deserves special attention. Although a substantial regression of rheumatic disease was recorded in our country, we have to take into account that there are patients after surgery of mitral stenosis made in the past, that restenosis may develop and that there is also a certain number of non-rheumatic forms of mitral stenosis. Clinical cardiological examination still remains the basis for evaluation of mitral stenosis. A central position in the diagnosis of mitral stenosis for assessment of structural morphological changes in the area of the mitral valve and functional flow changes in the cardiac area is played by echocardiography which, when modern techniques are used, usually suffices for indication of invasive treatment on the stenotic mitral valve. The drug of choice in selected patients with mitral stenosis is balloon mitral commissurotomy which clearly dominates in the majority of patients needing a radical procedure and leads to release of the close block in this area and substantial improvement or sometimes complete disappearance of the symptomatology of the disease. Similarly as in surgical commissurotomy this invasive procedure must be described as palliative and not as a curative procedure.
二尖瓣狭窄作为一种进行性疾病，即使在当下仍然是心脏病学中一个重要的专业诊断领域，值得特别关注。尽管我国记录到风湿性疾病有显著消退，但我们必须考虑到，过去有接受过二尖瓣狭窄手术的患者，可能会发生再狭窄，而且还有一定数量的非风湿性二尖瓣狭窄形式。临床心脏病学检查仍然是评估二尖瓣狭窄的基础。超声心动图在二尖瓣狭窄的诊断中占据核心地位，用于评估二尖瓣区域的结构形态变化以及心脏区域的功能性血流变化。当使用现代技术时，超声心动图通常足以指示对狭窄二尖瓣进行侵入性治疗。对于选定的二尖瓣狭窄患者，首选药物是球囊二尖瓣交界切开术，在大多数需要根治性手术的患者中，该方法明显占主导地位，可解除该区域的紧密阻塞，并使疾病症状得到显著改善，有时甚至完全消失。与外科交界切开术一样，这种侵入性手术必须被描述为姑息性而非根治性手术。
