退行性二尖瓣反流的临床治疗进展

Progress in clinical treatment of degenerative mitral regurgitation

随着许多国家老龄化的日趋发展及动脉粥样硬化危险因素的流行,退行性心脏瓣膜病发病率明显升高。退行性二尖瓣反流主要是由于黏液样变性(Barlow病)或弹性纤维缺乏引起二尖瓣关闭不全,另外部分患者则主要发生老年性钙化病变。手术是有症状重度退行性二尖瓣反流患者的首选治疗措施,而对于无症状患者的最佳治疗措施仍有争议。近年来微创二尖瓣修复如经皮穿刺导管治疗技术的发展为该病的治疗提供了新的方向。本文综述退行性二尖瓣反流的治疗现状及最新进展。

With the increasing problem of aging and cardiovascular atherosclerosis in many countries,the incidence of degenerative heart valvular disease is significantly increased. Myxomatous disease（ Barlow＇ s disease） and fibroelastic deficiency are the two dominant causes for degenerative mitral valve disease,and some other patients are mainly due to senile calcification. Surgery is the preferred treatment for those symptomatic patients with severe mitral regurgitation,while it is controversial about optimal treatment on asymptomatic patients. In recent years,minimally invasive mitral valve repair,such as percutaneous catheterization treatment,proviede a new option. This article reviews the treatment of degenerative mitral valve regurgitation disease and highlights the latest progress.