Kerckhoff Clinic, Bad Neuheim, Germany.
Heart Hospital Baylor Plano and Baylor University Medical Center, 621 N. Hall Street, Suite H030, Dallas, TX 75226, USA.
Eur Heart J. 2017 Mar 1;38(9):634-638. doi: 10.1093/eurheartj/ehv487.
Tricuspid regurgitation (TR) is the most common lesion of the tricuspid valve (TV). Mild TR is common and usually is benign. However, moderate or severe TR can lead to irreversible myocardial damage and adverse outcomes. Despite these findings, few patients with significant TR undergo surgery. The treatment of functional (secondary) TR in particular remains controversial because of high rates of residual or recurrent TR and poor outcomes following surgical intervention. Traditional teaching that functional TR resolves on its own if the underlying disease is successfully treated has proven to be incorrect. This review aims to clarify management of TR by describing the anatomy, pathophysiology, diagnosis, and treatment of TR, including the eventual possibility of percutaneous TV therapy.
三尖瓣反流(TR)是三尖瓣(TV)最常见的病变。轻度 TR 很常见,通常是良性的。然而,中度或重度 TR 可导致不可逆的心肌损伤和不良后果。尽管有这些发现,仍有少数严重 TR 患者接受手术治疗。特别是功能性(继发性)TR 的治疗仍然存在争议,因为手术后残余或复发 TR 的发生率较高,且预后较差。传统的观点认为,如果基础疾病得到成功治疗,功能性 TR 会自行消退,但事实证明这种观点是不正确的。本文旨在通过描述 TR 的解剖结构、病理生理学、诊断和治疗,包括经皮 TV 治疗的可能性,来澄清 TR 的管理。