Heart Institute, Cedars-Sinai Medical Center, 8631 W 3rd Street, Los Angeles, CA 90048, USA.
Curr Opin Cardiol. 2011 Mar;26(2):99-105. doi: 10.1097/HCO.0b013e32834398a0.
The rapid advancement in transcatheter therapies seeks to provide less invasive options compared with conventional surgery in the treatment of acquired valvular heart disease. A number of transcatheter mitral valve devices using a variety of approaches for the treatment of mitral regurgitation are under development or in early clinical application. Although yet to be clearly defined, there is no doubt that transcatheter mitral valve procedures will have a significant role alongside conventional surgery. The question is: will surgeons, who have led the treatment of mitral valve disease for the past 30 years, have a role in these procedures?
In order to answer this question, this review discusses key understanding of mitral valve anatomy, function and disorder required to perform transcatheter mitral valve interventions. It assesses the potential role of transcatheter therapies with particular reference to percutaneous edge-to-edge repair using the Mitraclip system (Abbott Vascular Devices, California, USA). The new era in collaboration between surgeons and cardiologists is discussed and the potential role of the surgeon in percutaneous mitral valve procedures is examined.
Transcatheter mitral valve procedures demand increasing collaboration between cardiologists and surgeons in order to achieve optimal outcomes. Interventional cardiologists will require dedicated training in the specialized field of transcatheter interventions in acquired structural heart diseases. As the delivery of such therapies brings the interface between interventional cardiology and cardiac surgery ever closer, there is the potential for a niche area in cardiac surgery to develop comprising minimally invasive surgical and transcatheter skills.
经导管治疗技术的快速发展旨在为获得性心脏瓣膜病的治疗提供比传统手术更具侵袭性的选择。目前有许多采用不同方法的经导管二尖瓣装置正在开发或早期临床应用，用于治疗二尖瓣反流。尽管尚未明确界定，但毫无疑问，经导管二尖瓣手术将与传统手术一起发挥重要作用。问题是：在过去 30 年中主导二尖瓣疾病治疗的外科医生是否会在这些手术中发挥作用？
为了回答这个问题，这篇综述讨论了进行经导管二尖瓣瓣膜干预所需的关键二尖瓣解剖、功能和障碍的理解。它评估了经导管治疗的潜在作用，特别是参考了使用 Mitraclip 系统（美国加利福尼亚州 Abbott Vascular Devices）的经皮边缘到边缘修复。讨论了外科医生和心脏病专家之间的新时代合作，并探讨了外科医生在经皮二尖瓣手术中的潜在作用。
为了实现最佳效果，经导管二尖瓣手术需要心脏病专家和外科医生之间日益密切的合作。介入心脏病专家需要在获得性结构性心脏病的经导管介入这一专业领域接受专门培训。随着这些治疗方法的应用，介入心脏病学和心脏外科学之间的接口越来越近，心脏外科学中可能会出现一个微创外科和经导管技能的利基领域。
