Maisano Francesco, Buzzatti Nicola, Taramasso Maurizio, Alfieri Ottavio
Cardiac Surgery Department, Ospedale San Raffaele, Milano, Italy.
Rambam Maimonides Med J. 2013 Jul 25;4(3):e0015. doi: 10.5041/RMMJ.10115. Print 2013 Jul.
Mitral valve regurgitation (MR) is often diagnosed in patients with heart failure and is associated with worsening of symptoms and reduced survival. While surgery remains the gold standard treatment in low-risk patients with degenerative MR, in high-risk patients and in those with functional MR, transcatheter procedures are emerging as an alternative therapeutic option. MitraClip(®) is the device with which the largest clinical experience has been gained to date, as it offers sustained clinical benefit in selected patients. Further to MitraClip implantation, several additional approaches are developing, to better match with the extreme variability of mitral valve disease. Not only repair is evolving, initial steps towards percutaneous mitral valve implantation have already been undertaken, and initial clinical experience has just started.
二尖瓣反流(MR)在心力衰竭患者中经常被诊断出来,并且与症状恶化和生存率降低有关。虽然手术仍然是低风险退行性二尖瓣反流患者的金标准治疗方法,但在高风险患者和功能性二尖瓣反流患者中,经导管手术正逐渐成为一种替代治疗选择。MitraClip(®)是迄今为止积累了最大临床经验的设备,因为它在特定患者中提供持续的临床益处。除了MitraClip植入术之外,还有几种其他方法正在开发中,以更好地适应二尖瓣疾病的极端变异性。不仅修复技术在不断发展,经皮二尖瓣植入术也已经迈出了初步步伐,并且刚刚开始了初步临床经验积累。