Wißt T, Kreidel F, Schlüter M, Kuck K-H, Frerker C
Abteilung für Kardiologie, II. Medizinische Klinik, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland.
Asklepios Proresearch, Hamburg, Deutschland.
Internist (Berl). 2017 Nov;58(11):1222-1230. doi: 10.1007/s00108-017-0329-6.
The tricuspid valve can be considered the "forgotten" valve because in the past hardly any research has been conducted in this field and as a result only few therapeutic options existed. The prognosis of untreated tricuspid regurgitation (TR) is poor and mortality is high for patients with severe TR. Patients frequently return to medical practices and hospitals because of cardiac decompensation, with shortness of breath and leg edema.
Recent years have seen more development in catheter-based treatment options. Currently, several devices are in clinical evaluation, which are presented in this article.
A web-based literature search was carried out and information was gathered at international cardiology meetings (TCT 2016 in Washington, DGK 2017 in Mannheim, EuroPCR 2017 in Paris).
There are various options for interventional catheter procedures for TR, which are being investigated within the scope of clinical studies. Most aim at reducing the tricuspid annular diameter and optimizing leaflet coaptation. Because of these new therapy options patients can now be treated who were considered untreatable in the past because of the high perioperative mortality.
三尖瓣可被视为“被遗忘的”瓣膜,因为过去该领域几乎没有开展任何研究,因此治疗选择很少。未经治疗的三尖瓣反流(TR)预后较差,重度TR患者的死亡率较高。患者常因心脏失代偿、呼吸急促和腿部水肿而频繁返回医疗机构和医院。
近年来,基于导管的治疗选择有了更多发展。目前,有几种装置正在进行临床评估,本文将对其进行介绍。
进行了基于网络的文献检索,并在国际心脏病学会议(2016年于华盛顿召开的经导管心血管治疗学术会议、2017年于曼海姆召开的德国心脏病学会年会、2017年于巴黎召开的欧洲心血管介入学会年会)上收集信息。
TR的介入导管手术有多种选择,正在临床研究范围内进行研究。大多数旨在减小三尖瓣环直径并优化瓣叶对合。由于有了这些新的治疗选择,过去因围手术期死亡率高而被认为无法治疗的患者现在可以得到治疗了。