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三尖瓣反流的当前治疗策略

Current Treatment Strategies for Tricuspid Regurgitation.

作者信息

Al-Hijji Mohammed, Fender Erin A, El Sabbagh Abdallah, Holmes David R

机构信息

Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.

出版信息

Curr Cardiol Rep. 2017 Sep 14;19(11):106. doi: 10.1007/s11886-017-0920-4.

Abstract

PURPOSE OF REVIEW

Tricuspid regurgitation is common; however, recognition and diagnosis, clinical outcomes, and management strategies are poorly defined. Here, we will describe the etiology and natural history of tricuspid regurgitation (TR), evaluate existing surgical outcomes data, and review the evolving field of percutaneous interventions to treat TR.

RECENT FINDINGS

Previously, the only definitive corrective therapy for TR was surgical valve repair or replacement which is associated with significant operative mortality. Advances in percutaneous valve repair techniques are now being translated to the tricuspid valve. These novel interventions may offer a lower-risk alternative treatment in patients at increased surgical risk. Significant TR adversely impacts survival. Surgery remains the only proven therapy for treatment of TR and may be underutilized due to mixed outcomes data. Early experience with percutaneous interventions is promising, but large clinical experience is lacking. Further study will be required before these therapies are introduced into broader clinical practice.

摘要

综述目的

三尖瓣反流很常见;然而,其识别与诊断、临床结局及管理策略尚不明确。在此,我们将描述三尖瓣反流(TR)的病因及自然史,评估现有的手术结局数据,并回顾治疗TR的经皮介入这一不断发展的领域。

最新发现

此前,TR唯一确定的矫正疗法是外科瓣膜修复或置换,这与显著的手术死亡率相关。经皮瓣膜修复技术的进展目前正应用于三尖瓣。这些新型干预措施可能为手术风险增加的患者提供风险较低的替代治疗。严重TR对生存有不利影响。手术仍然是治疗TR的唯一经证实的疗法,由于结局数据不一,可能未得到充分利用。经皮介入的早期经验很有前景,但缺乏大型临床经验。在这些疗法被引入更广泛的临床实践之前,还需要进一步研究。

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