Introduction: Mitral valve prolapse (MVP) is a common valve pathology with a spectrum of disease from isolated prolapse to myxomatous, multi-scallop Barlow’s disease. The main complications relate to progression of mitral regurgitation, endocarditis, sudden death, and stroke. The timing of intervention in patients with asymptomatic severe mitral regurgitation is controversial.
Areas covered: This article reviews the pathophysiology, genetics, clinical features, diagnostic imaging, complications, long-term outcomes, and indications for intervention in MVP.
Expert commentary: Several key dilemmas in the management of MVP remain. Factors which influence progression of mitral regurgitation are unclear and therefore, we have no therapeutic targets to prevent progression. Evidence-based methods to reduce the risk of sudden death, stroke, and endocarditis have not been identified. In symptomatic patients with severe mitral regurgitation valve surgery is recommended. In asymptomatic patients, careful risk stratification incorporating markers of left ventricular dysfunction, atrial fibrillation, pulmonary hypertension, and valve reparability is required to identify the optimal timing of intervention. 相似文献
A 67-year-old woman had aortic and mitral annulus calcification resulting in severe stenosis and incompetence of the valves. Mitral annulus calcification produces specific echocardiographic abnormalities which may forewarn of technical difficulties during surgery. 相似文献
Diseases that affect the mitral valve include mitral regurgitation, mitral stenosis, rheumatic heart disease, and cardiomyopathy. The results of diagnostic procedures are used to identify and confirm mitral valve disease, evaluate the patient's anatomy, and determine the severity of the disease. After the patient is prepared for surgery, the surgeon performs an intraoperative transesophageal echocardiogram and the patient is placed on cardiopulmonary bypass. A repair procedure (eg, annuloplasty, slidingplasty, chordal repair/transfer/replacement, valve replacement) is performed depending on the patient's specific anatomical abnormalities. 相似文献