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首页> 外文期刊>Current opinion in anaesthesiology >Mitral valve repair or replacement in elderly people.
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Mitral valve repair or replacement in elderly people.

机译：老年人二尖瓣的修复或更换。

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PURPOSE OF REVIEW: Much has been published so far to describe and praise the benefits of mitral valve repair, and to compare it with valve replacement. Now, with mitral valve surgery in elderly people gaining greater acceptance worldwide, repair or replacement remains a controversial issue. This is especially true in the ageing population, in whom many of the complications associated with a mechanical valve can be avoided by using a bioprosthesis. This review will try to assess the latest views in the field and come up with possible answers to this ongoing question. RECENT FINDINGS: The causes of mitral regurgitation in this age group are separately reviewed and discussed in the light of our better understanding of the pathophysiology of the disease. Mitral surgery is recommended when the effective regurgitant orifice reaches 40 mm. Repair in degenerative disease seems to be feasible, with good long-term results. In chronic ischaemic regurgitation, the concept of a tethered 'normal valve' is changing. The 'poor' ventricle may be able to withstand surgery as long as the subvalvular apparatus is preserved; on the other hand, repair and replacement seem to have the same survival advantage in high-risk patients. SUMMARY: Mitral valve surgery is well tolerated in elderly people. Early intervention leads inevitably to better outcome. The majority of valvular disorders in this age group are amenable to repair, with good reproducible results. Replacement with a bioprosthesis remains a viable option for complex regurgitant jets.
机译：审查的目的：迄今为止，已经有很多出版物描述和赞扬二尖瓣修复的好处，并将其与瓣膜置换术进行比较。现在，随着老年人二尖瓣手术的广泛使用，维修或更换仍然是一个有争议的问题。这在老龄化人群中尤其如此，其中使用生物假体可以避免许多与机械瓣膜相关的并发症。这次审查将尝试评估该领域的最新观点，并为这个持续存在的问题提供可能的答案。最近的发现：根据我们对该疾病的病理生理学的更好理解，分别回顾和讨论了该年龄组二尖瓣关闭不全的原因。当有效的反流口达到40 mm时，建议进行二尖瓣手术。退化性疾病的修复似乎是可行的，并具有良好的长期效果。在慢性缺血性反流中，拴系“正常瓣膜”的概念正在发生变化。只要保留了瓣膜下装置，“差”的心室就可以承受手术。另一方面，高危患者的修复和置换似乎具有相同的生存优势。简介：老年人对二尖瓣手术的耐受性良好。早期干预不可避免地导致更好的结果。这个年龄段的大多数瓣膜疾病都可以修复，可重复性好。对于复杂的反流式射流，用生物假体替代仍然是可行的选择。

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