老年瓣膜性心脏病的诊治进展

Diagnosis and treatment progress of valvular heart disease in older patients

瓣膜性心脏病的发生发展与年龄密切相关,随着年龄增长,瓣膜病发生率也随之增加。在老年人群中,退行性主动脉瓣狭窄和二尖瓣反流是最常见的瓣膜性心脏病。严重的瓣膜性心脏病可导致心力衰竭、心律失常甚至死亡等后果,然而对于有症状的重度瓣膜病患者来说,常规药物治疗疗效甚微,且因合并多种并发症常被认为是不适宜外科手术的高危群体。随着外科手术技术的不断创新和经导管介入技术的发展,老年瓣膜病患者的治疗方式也有了更多的选择。

Valvular heart disease is highly associated with age and the incidence is increasing as a person ages. Aortic stenosis and mitral regurgitation are the most common valvular disease type in older adults. Severe valvular disease is associated with heart failure, arrhythmia and death. As medical therapy is ineffective in the treatment of severe symptomatic valvular disease, surgery is recommended according to guildlines. However, older adults are often deemed as high-risk group for surgery because of the presence of comorbidities and frailty in the elderly. As a result of advances in surgical techniques and catheter-based technologies, aging patients who were deemed ＇too old/sick＇ are now being offered many more treatment choices.