How do we use imaging to aid considerations for intervention in patients with severe mitral regurgitation?
How do we use imaging to aid considerations for intervention in patients with severe mitral regurgitation?
复制标题
我们如何使用影像学来帮助考虑对严重二尖瓣反流患者进行干预？
DOI：
10.3978/j.issn.2225-319x.2013.10.02
复制
发表时间：
2013
影响因子：
3.1
通讯作者：
Randolph P. Martin
中科院分区：
文献类型：
--
作者：
Randolph P. Martin
预期寿命的增加和肥胖等共病，特别是在工业化国家，导致瓣膜性心脏病（VHD）成为一种主要流行病。二尖瓣疾病目前占全球工业化国家瓣膜性心脏病的近10%。已知的事实是，如果不进行治疗，退行性二尖瓣疾病不仅缩短了个体的寿命，而且还与发病率增加有关。尽管有目前的指导方针，但在适当地将患者送去考虑手术干预方面往往存在明显的延迟，手术干预如果执行良好，可以显着地使患者恢复到更正常的寿命。关键的问题不是二尖瓣返流的严重程度，而是二尖瓣返流对心脏的影响。利用经胸超声心动图、负荷超声心动图和经食管超声心动图的现代超声心动图可以为临床医生和外科医生提供六个关键因素，这些因素结合在一起可以为二尖瓣修复术的适当时机提供明确的指导。综合考虑这些因素，临床医生和外科医生可以更适当地选择原发性退行性二尖瓣返流的适当手术干预时间。
Increasing life expectancy and comorbid conditions, like obesity, especially in industrialized countries, have led to Valvular Heart Disease (VHD) becoming a major epidemic. Mitral valve disease currently accounts for nearly 10% of Valvular Heart Disease in industrialized countries worldwide. It is a known fact that, left untreated, degenerative mitral valve disease not only shortens an individual's life, but is also associated with increased morbidity. Despite current guidelines, there is often marked delay in appropriately sending patients for consideration of surgical intervention-interventions that when performed well can dramatically restore patients to a more normal lifespan. The critical question is really not what the severity of the mitral regurgitation is, but what the effect of the mitral regurgitation is on the heart. Modern day echocardiography utilizing Transthoracic Echo, Stress Echo, and Transesophageal Echo, can provide the clinician and the surgeon with six key factors that when taken together provide clear direction as to the proper timing for consideration for mitral valve repair. Thinking of these in an integrative fashion, the clinician and the surgeon can more appropriately time proper surgical intervention in primary degenerative mitral regurgitation.