Wagner Robert, Daehnert Ingo, Lurz Philipp
Robert Wagner, Ingo Daehnert, Department of Paediatric Cardiology, University of Leipzig-Heart Center, D-04289 Leipzig, Germany.
World J Cardiol. 2015 Apr 26;7(4):167-77. doi: 10.4330/wjc.v7.i4.167.
The field of percutaneous valvular interventions is one of the most exciting and rapidly developing within interventional cardiology. Percutaneous procedures focusing on aortic and mitral valve replacement or interventional treatment as well as techniques of percutaneous pulmonary valve implantation have already reached worldwide clinical acceptance and routine interventional procedure status. Although techniques of percutaneous pulmonary valve implantation have been described just a decade ago, two stent-mounted complementary devices were successfully introduced and more than 3000 of these procedures have been performed worldwide. In contrast, percutaneous treatment of tricuspid valve dysfunction is still evolving on a much earlier level and has so far not reached routine interventional procedure status. Taking into account that an "interdisciplinary challenging", heterogeneous population of patients previously treated by corrective, semi-corrective or palliative surgical procedures is growing inexorably, there is a rapidly increasing need of treatment options besides redo-surgery. Therefore, the review intends to reflect on clinical expansion of percutaneous pulmonary and tricuspid valve procedures, to update on current devices, to discuss indications and patient selection criteria, to report on clinical results and finally to consider future directions.
经皮瓣膜介入领域是介入心脏病学中最令人兴奋且发展迅速的领域之一。专注于主动脉瓣和二尖瓣置换或介入治疗的经皮手术以及经皮肺动脉瓣植入技术已在全球范围内获得临床认可并成为常规介入手术。尽管经皮肺动脉瓣植入技术在仅仅十年前才被描述,但两种支架式辅助装置已成功推出,全球范围内已进行了3000多例此类手术。相比之下,经皮三尖瓣功能障碍的治疗仍处于更早的发展阶段,迄今为止尚未达到常规介入手术的地位。考虑到此前接受矫正、半矫正或姑息性外科手术治疗的患者群体“跨学科挑战性”强且异质性大,并且这一群体在无情地增长,除了再次手术外,对治疗选择的需求迅速增加。因此,本综述旨在反思经皮肺动脉瓣和三尖瓣手术的临床扩展情况,更新当前器械,讨论适应症和患者选择标准,报告临床结果,并最终考虑未来方向。