二尖瓣疾病瓣膜置换术后右心功能及瓣膜功能的超声评价

Ultrasound Evaluation of Right Heart Function and Valve Function after Mitral Valve Replacement

对二尖瓣的功能解剖和不同疾病引起的改变的了解是外科医生治疗二尖瓣疾病必不可少的。在发展中国家,风湿性二尖瓣疾病仍然是最常见的心脏瓣膜疾病。只要修复效果比置换术好,只要有可能,就应该进行修复。术中决定修复或置换并不总是简单的,这取决于外科医生的经验和引起二尖瓣功能障碍的病理变化。心衰患者右心室功能受损与生存率低相关。很少有研究分析右室功能对二尖瓣手术预后的影响。因此,超声评价二尖瓣疾病瓣膜置换术后右心功能及瓣膜功能具有实际意义。

A sound knowledge of the functional anatomy of the mitral valve and the alterations caused by dif-ferent diseases is indispensable for surgeons treating patients with mitral valve disease. Rheumatic mitral valve disease remains the most common heart valvular disorder in developing countries. The mitral valve should be repaired whenever possible, as long as the outcome is predictably better than that of replacement. The intraoperative decision to repair or replace is not always simple and depends on the experience of the surgeon and the pathological changes that caused mitral valve dysfunction. An impaired right ventricular function is associated with a poor survival rate in pa-tients with heart failure. Few investigations have analyzed the prognostic value of right ventricular function on the outcomes of mitral valve (MV) surgery. Therefore, ultrasonic evaluation of right heart function and valve function after mitral valve replacement is of practical significance.