Meier Pascal, Franzen Olaf, Lansky Alexandra J
Yale-UCL Cardiovascular Research Program, The Heart Hospital, University College London Hospitals UCLH, London-UK; Division of Cardiology, Yale Medical School, New Haven, Connecticut-USA.
Anadolu Kardiyol Derg. 2013 Sep;13(6):622-31. doi: 10.5152/akd.2013.224. Epub 2013 Sep 10.
Recent innovations in interventional cardiology have dramatically expanded the therapeutic options for patients with cardiac conditions. Interventional cardiology is no longer limited to the treatment of coronary artery disease but allows also treatment of valvular disease, stroke prevention, hypertension, etc. One of the most important new treatment options is the percutaneous treatment for aortic valve stenosis (transcatheter aortic valve implantation), since aortic valve disease is a rather common problem in elderly patients, with many of them at high risk for surgery. Similarly, mitral regurgitation is often associated with comorbidities which make surgery high risk. The MitraClip is a promising percutaneous alternative to surgical valve repair or replacement. Other procedures discussed in this review are the percutaneous left atrial appendage closure as a non-pharmacologic therapy to prevent strokes, and renal denervation for resistant hypertension. This review explains the basic principles of these procedures, the most important clinical evidence, and also provides additional recent clinical data on each of these them.
近年来,介入心脏病学的创新极大地扩展了心脏病患者的治疗选择。介入心脏病学不再局限于治疗冠状动脉疾病,还可用于治疗瓣膜疾病、预防中风、高血压等。最重要的新治疗选择之一是经皮治疗主动脉瓣狭窄(经导管主动脉瓣植入术),因为主动脉瓣疾病在老年患者中是一个相当常见的问题,其中许多人手术风险很高。同样,二尖瓣反流通常与合并症相关,这使得手术风险很高。MitraClip是一种有前景的经皮替代手术瓣膜修复或置换的方法。本综述中讨论的其他手术包括经皮左心耳封堵术作为预防中风的非药物治疗方法,以及用于顽固性高血压的肾去神经术。本综述解释了这些手术的基本原理、最重要的临床证据,并提供了关于每种手术的最新临床数据。