Vahanian Alec, Juliard Jean M, Brochet Eric
Department of Cardiology, Hôpital Bichat, University of Paris VI, Paris, France -
Department of Cardiology, Hôpital Bichat, University of Paris VI, Paris, France.
Minerva Cardioangiol. 2017 Oct;65(5):500-503. doi: 10.23736/S0026-4725.17.04369-9. Epub 2017 Mar 1.
Severe functional tricuspid regurgitation (FTR) is frequent and carries a poor prognosis when left untreated. The strategy in symptomatic patients should be decided by a Heart Team who will choose between valve surgery, transcatheter intervention, heart transplantation or palliative medical therapy. The field of application of transcatheter tricuspid valve therapy will certainly focus on inoperable or high-risk patients first, especially those with FTR occurring late after left-sided valve surgery. If surgery is contraindicated because of multiple comorbidities interventions which are likely to be "futile" should be avoided. Conversely, if life expectancy is acceptable, it is attractive to envisage percutaneous intervention. Thus, there is a clinical need for transcatheter tricuspid valve therapies when surgery is not an option. Controlled clinical studies are necessary to show the safety profile and the performance of the new transcatheter procedures and define their potential role.
重度功能性三尖瓣反流（FTR）很常见，若不治疗，预后较差。有症状患者的治疗策略应由心脏团队决定，他们将在瓣膜手术、经导管介入治疗、心脏移植或姑息性药物治疗之间做出选择。经导管三尖瓣治疗的应用领域肯定会首先聚焦于无法手术或高风险患者，尤其是那些在左侧瓣膜手术后晚期出现FTR的患者。如果因多种合并症而禁忌手术，应避免可能“无效”的干预措施。相反，如果预期寿命可以接受，考虑经皮介入治疗很有吸引力。因此，当手术不可行时，临床上需要经导管三尖瓣治疗。需要进行对照临床研究以显示新的经导管手术的安全性和性能，并确定其潜在作用。
