Yale-UCL Cardiovascular Research Program, The Heart Hospital, University College London Hospitals UCLH, 16-18 Westmoreland Street, W1G 8PH, London, UK,
Wien Klin Wochenschr. 2013 Dec;125(23-24):766-75. doi: 10.1007/s00508-013-0481-5.
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.
最近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,还可以治疗瓣膜疾病、预防中风、高血压等。其中最重要的新治疗选择之一是经皮主动脉瓣狭窄(经导管主动脉瓣植入术)治疗,因为老年患者中主动脉瓣疾病是一个相当常见的问题,其中许多患者手术风险较高。同样,二尖瓣反流通常与使手术风险高的合并症相关。MitraClip 是一种有前途的经皮二尖瓣瓣叶修复或置换替代方法。本文还讨论了其他一些程序,例如经皮左心耳封堵术作为预防中风的非药物治疗,以及肾去神经术治疗难治性高血压。本文解释了这些程序的基本原理、最重要的临床证据,并提供了关于这些程序的最新临床数据。