Herz-Gefäss Chirurgie, UniversitätsSpital Zürich, University of Zürich, Rämistrasse 100, Zurich 8091, Switzerland.
Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy.
Eur Heart J. 2017 Mar 1;38(9):639-647. doi: 10.1093/eurheartj/ehv766.
Moderate-to-severe tricuspid regurgitation (TR) affects ∼1.6 million patients in the USA, of whom only 8000 undergo tricuspid surgery annually; this results in an extremely large number of untreated patients with significant TR. Therefore, there is a large unmet clinical need for patients with severe TR who are not referred for conventional surgery, mainly due to expected high surgical risk. Percutaneous procedures are an attractive alternative to surgery for patients deemed to be high-risk surgical candidates. Whereas over the past few years, the development and clinical use of percutaneous approaches to the aortic valve and mitral valve have been widespread, few data are available about the feasibility and the efficacy of the percutaneous tricuspid valve treatment. This review will explore the available technologies, which are today under evaluation and the preliminary clinical results.
中重度三尖瓣反流(TR)影响了美国约 160 万名患者,其中每年仅有 8000 名患者接受三尖瓣手术;这导致大量未经治疗的严重 TR 患者存在,而这些患者存在显著的临床需求。因此,对于那些因预期手术风险高而未被推荐接受常规手术的严重 TR 患者,存在着巨大的未满足的临床需求。对于被认为是高危手术候选者的患者来说,经皮手术是手术的一种有吸引力的替代方法。虽然在过去几年中,经皮主动脉瓣和二尖瓣介入治疗的发展和临床应用已经很广泛,但关于经皮三尖瓣治疗的可行性和疗效的数据很少。本综述将探讨现有的技术,这些技术正在评估中,同时也将介绍初步的临床结果。