Mitral valve problems

二尖瓣是心脏中的一个小瓣，阻止了流血的方式。它的问题会影响血液如何在身体周围流动。

The main problems that affect the mitral valve are:

• 二尖瓣脱垂 - 阀变软
• mitral regurgitation – the valve leaks and blood flows the wrong way
• 二尖瓣狭窄 - 阀门没有应有的宽度

These conditions can be serious, but they're often treatable.

In some cases, mitral valve surgery may be needed.

二尖瓣脱垂

二尖瓣脱垂is where the mitral valve is too floppy and does not close tightly.

症状

Many people with a mitral valve prolapse do not have symptoms and it may only be spotted during a heart scan(echocardiogram)进行另一个原因。

二尖瓣脱垂can sometimes cause:

• dizziness
• breathlessness
• tiredness
• an irregular heartbeat(arrhythmia)或明显的心跳(palpitations)
• mitral regurgitation

治疗

如果您没有任何症状，您可能不需要治疗。

Your doctor may suggest:

• 改变生活方式，例如戒烟，咖啡因和酒精 - 这些事情可能会使您的心脏过于努力
• having regular check-ups to monitor your condition

If you have symptoms or your mitral valve is very floppy, your doctor may recommend:

• medicine to relieve your symptoms, such asbeta blockersfor an irregular heartbeat
• 二尖瓣手术以修复或更换二尖瓣

Causes

二尖瓣脱垂is usually caused by problems with the tissues that join the mitral valve to the heart muscles.

Some people with the condition are born with it, and it's more common in people with connective tissue disorders, such asMarfan syndrome.

Rarely, it can be caused by damage to the heart muscles themselves – for example, as the result of a心脏病发作.

Mitral regurgitation

二尖瓣反流是某些血液在心脏中流动错误的地方，因为二尖瓣无法正确关闭。

症状

Mitral valve regurgitation does not always have symptoms.

Sometimes it can cause:

• dizziness
• breathlessness
• tiredness
• 胸痛

If not treated, it can lead to:

• atrial fibrillation– an irregular and fast heartbeat
• pulmonary hypertension– high blood pressure in the blood vessels that supply the lungs
• heart failure– where the heart cannot pump enough blood around the body

治疗

如果您没有任何症状，则可能不需要治疗。您的医生可能只建议进行定期检查以监控您的病情。

如果您有症状或阀门问题很严重，您的医生可能会建议：

• 可以减轻症状的药物，例如利尿剂，以减少呼吸困难和medicines for atrial fibrillation
• 心脏手术 - 修理或更换二尖瓣
• 钥匙孔手术 - 二尖瓣附着一个小夹子，以帮助其关闭；夹子通过插入腹股沟静脉的细管引导到心脏

Causes

如果二尖瓣无法正确关闭，则二尖瓣反流。

This is usually caused by either:

• the mitral valve becoming too floppy (mitral valve prolapse)
• the ring of muscle around the valve becoming too wide

These problems often develop with age – for example, because of "wear and tear" over time or damage caused by untreatedhigh blood pressure.

二尖瓣反流有时可能是由以下问题引起的：

• 心肌病- 心脏壁伸展，增厚或僵硬的地方
• 心内膜炎– infection of the inner lining of the heart
• congenital heart disease– birth defects affecting the heart

Mitral stenosis

Mitral valve stenosis is where the mitral valve does not open as wide as it should, restricting the flow of blood through the heart.

症状

Mitral valve stenosis may not have any symptoms.

Sometimes it can cause:

• dizziness
• breathlessness
• tiredness
• 明显的心跳(palpitations)
• 胸痛

If not treated, it can lead to:

• atrial fibrillation– an irregular and fast heartbeat
• pulmonary hypertension– high blood pressure in the blood vessels that supply the lungs
• heart failure– where the heart cannot pump blood around the body properly

治疗

如果您没有任何症状，则可能不需要治疗。您的医生可能只建议进行定期检查以监控您的病情。

如果您有症状或阀门问题很严重，您的医生可能会建议：

• medicine to relieve your symptoms – such as medicines called diuretics to reduce breathlessness andmedicines for atrial fibrillation
• mitral valve surgery – to replace the valve or a procedure to stretch it with a small balloon (balloon valvuloplasty)

Causes

One of the main causes of mitral valve stenosis isrheumatic heart disease.

This is where an infection causes the heart to become inflamed. Over time, it can cause the flaps of the mitral valve to become hard and thick.

其他原因包括随着年龄的年龄形成阀周围形成的硬沉积物，或出生时心脏的问题（先天性心脏病）.

二尖瓣手术

二尖瓣手术may be recommended if you have symptoms caused by a problem with your mitral valve or if the problem is quite serious.

The most common mitral valve procedures are:

• 二尖瓣修复
• 二尖瓣更换
• 气球瓣膜成形术 - 二尖瓣有一个小气球

Mitral valve repair

二尖瓣修复是使二尖瓣的襟翼保持更近的操作。这将有助于阻止血液通过阀门流动。

It's mainly used to treat mitral valve prolapse or regurgitation, if the problem is serious and causing symptoms.

The operation is carried out undergeneral anaesthetic, where you're asleep.

您的外科医生通常会通过胸部中间的一次切割，但有时会使用肋骨之间的较小切割。

然后将二尖瓣的襟翼部分缝合在一起。

该操作可以作为钥匙孔手术进行，其中将小夹子连接到二尖瓣以帮助其关闭。

Most people experience a significant improvement in their symptoms after surgery, but speak to your surgeon about the possible complications.

二尖瓣更换

二尖瓣置换是用机械阀或由动物组织（生物假体阀）制成的阀门替代二尖瓣的操作。

This is usually only done if you have mitral stenosis or mitral prolapse or regurgitation and are unable to have a valve repair.

The operation is carried out undergeneral anaesthetic, where you're asleep. Your surgeon will usually replace the valve through a single cut along the middle of your chest.

Most people experience a significant improvement in their symptoms after surgery, but speak to your surgeon about the possible complications. The risk of serious problems is generally higher than with mitral valve repair.

You'll also need to take medicine to prevent blood clots for a long time after this operation. If you have a mechanical valve, you'll need to take this medicine for life.

Balloon valvuloplasty

Balloon valvuloplasty, also called percutaneous mitral commissurotomy, is a procedure that can be used to widen the mitral valve if you have mitral stenosis.

It's usually done using局部麻醉, where you remain awake but your skin is numbed.

腹股沟或脖子上有一个小切口，沿着血管将细管传递到您的心脏。

The end of the catheter has a small balloon attached to it. This is inflated inside the narrowed valve to stretch it wider. The balloon is then deflated and removed along with the catheter.

This procedure is generally less effective than replacing the mitral valve, but recovery tends to be quicker and it may be a better option if your valve is not too narrow or you're at an increased risk of surgery complications (for example, if you're pregnant or frail).