问题:二尖瓣狭窄

什么是二尖瓣狭窄?

Mitral stenosis is a narrowing of the mitral valve opening. Mitral stenosis restricts blood flow from the left atrium to the left ventricle.

Watch a mitral valve stenosis animation.

What problems can result from untreated or advanced mitral valve stenosis?

Mitral stenosis causes reduced blood flow through the narrowed valve opening from the left atrium to the left ventricle. As a result, the volume of blood bringing oxygen from the lungs is reduced. This can make you feel tired and short of breath. The volume and pressure from blood remaining in the left atrium increases, which causes the left atrium to enlarge and fluid to build up in the lungs.

什么原因导致二尖瓣狭窄?

Mitral stenosis can be caused by congenital heart defects, 二尖瓣脱垂, 风湿热, 红斑狼疮和其他疾病. 风湿热(PDF) is a childhood illness that sometimes occurs after untreated strep throat or scarlet fever.

Rheumatic fever is rare in high-income countries such as the United States but remains a concern in some low- and middle-income nations. Rheumatic fever can damage the heart valves, leading to rheumatic heart disease, or RHD. Mitral stenosis resulting from RHD is called rheumatic mitral stenosis. Although most mitral stenosis is caused by RHD, it can also result from a calcium buildup on the heart valves. This is more common in older patients and is called calcific mitral stenosis. 

二尖瓣狭窄可以治疗吗?

Although medications can’t fix a valve defect, they can help with symptoms. Your health care team may prescribe diuretics to reduce fluid accumulation in the lungs, blood thinners* to prevent clots from forming or drugs to control the heart rhythm if those are indicated. 二尖瓣通常可以 修理 or 取代 with surgery or a minimally invasive procedure. The choice of procedure is based on many factors including the cause of the mitral stenosis (rheumatic or calcific), 阀门状况, 手术风险, 症状的严重程度, heart function and availability of procedures.

二尖瓣合拢切开术
For rheumatic mitral stenosis, a commissurotomy may be performed. During this procedure the valve leaflets that have become fused together are separated. This can be done using a balloon (percutaneous mitral balloon commissurotomy or PMBC) or surgery. 这两种情况, once the leaflets have been separated, the valve opening is increased and blood flow through the valve is improved. In more advanced rheumatic mitral valve stenosis, surgical repair or replacement of the mitral valve may be required.