Mitral Valve Surgery in Advanced Heart Failure

被引:102
作者
Di Salvo, Thomas G. [1 ]
Acker, Michael A. [2 ]
Dec, G. William [3 ]
Byrne, John G. [1 ]
机构
[1] Vanderbilt Univ, Nashville, TN USA
[2] Univ Penn, Philadelphia, PA 19104 USA
[3] Massachusetts Gen Hosp, Boston, MA 02114 USA
关键词
mitral regurgitation; heart failure; cardiac surgery; CARDIAC RESYNCHRONIZATION THERAPY; LEFT-VENTRICULAR FUNCTION; COLLEGE-OF-CARDIOLOGY; LONG-TERM SURVIVAL; DILATED CARDIOMYOPATHY; AFTERLOAD REDUCTION; SURGICAL-TREATMENT; SUPPORT DEVICE; REGURGITATION; REPAIR;
D O I
10.1016/j.jacc.2009.08.059
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The appropriateness and timing of mitral valve surgery in patients with advanced heart failure and severe mitral regurgitation remains controversial. Recent surgical results provide evidence for beneficial effects on left ventricular remodeling and functional capacity. Given the absence of randomized trials comparing the outcomes of mitral valve surgery to medical therapy, however, clinical decision making regarding surgery for these fragile patients poses a dilemma to thoughtful clinicians. This paper reviews the pathophysiology of mitral regurgitation in heart failure and proposes an integrated approach to management. (J Am Coll Cardiol 2010; 55: 271-82) (C) 2010 by the American College of Cardiology Foundation
引用
收藏
页码:271 / 282
页数:12
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