Brüstle Karina, Calen Christelle, Kuwata Shingo, Nietlispach Fabian, Zuber Michel, Maisano Francesco, Taramasso Maurizio
Cardiovascular Surgery Department, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Cardiology Department, University Hospital of Zurich, Zurich, Switzerland.
Curr Treat Options Cardiovasc Med. 2017 Mar;19(3):18. doi: 10.1007/s11936-017-0521-y.
Tricuspid regurgitation is frequent and is most often caused by annular dilatation and leaflet tethering from adverse right ventricular remodeling in response to several disease processes (functional tricuspid regurgitation), while primary/organic tricuspid valve regurgitation is less common. Surgical intervention for tricuspid regurgitation is usually performed concomitantly to left-sided heart valve surgery. In isolated significant tricuspid regurgitation, however, many patients are left unoperated as they commonly are considered at very high or prohibitive surgical risk. Moreover, the risk versus benefit data are not as well-established as compared to other valve disease. Multiple novel transcatheter therapies have now begun to emerge with the aim to treat tricuspid regurgitation less invasively. For most new interventional procedures, current trials are designed to prove efficacy and safety. In the foreseeable future, however, patients with significant MR can likely be offered a multifaceted palette of minimally invasive transcatheter options in addition to conventional surgery, which will allow to treat more patients in need. These current developments make tricuspid valve disease and its therapy an exciting field of study.
三尖瓣反流很常见，最常见的原因是由于多种疾病过程导致右心室不良重塑引起的瓣环扩张和瓣叶牵拉（功能性三尖瓣反流），而原发性/器质性三尖瓣反流则较少见。三尖瓣反流的外科手术通常与左侧心脏瓣膜手术同时进行。然而，在孤立性严重三尖瓣反流中，许多患者未接受手术，因为他们通常被认为手术风险非常高或过高。此外，与其他瓣膜疾病相比，风险与获益的数据尚未得到充分确立。现在已经出现了多种新型经导管治疗方法，旨在以微创方式治疗三尖瓣反流。对于大多数新的介入手术，目前的试验旨在证明其有效性和安全性。然而，在可预见的未来，除了传统手术外，重度三尖瓣反流患者可能还会有多种微创经导管治疗选择，这将使更多有需要的患者得到治疗。这些当前的进展使三尖瓣疾病及其治疗成为一个令人兴奋的研究领域。
