Center for Interventional and Vascular Therapy, Columbia University Medical Center, New York, NY, USA.
EuroIntervention. 2017 Sep 24;13(AA):AA31-AA39. doi: 10.4244/EIJ-D-17-00673.
Mitral regurgitation (MR) is the second most common valvular heart disease in the western world with a prevalence in the USA alone of two to four million people. MR is age-dependent and hence the MR burden is expected to increase with the increase in life expectancy observed in Europe and the USA. Medical and surgical treatment has been the cornerstone of the treatment as untreated MR results in poor prognosis. However, only a fraction of patients are offered surgical treatment due to high risk. With the success of transcatheter aortic valve implantation (TAVI), many transcatheter options have emerged to provide a less invasive option for these patients. On the one hand, the repair options appear less invasive but tend to reduce the MR, while on the other hand the replacement options can eliminate the MR but could be more invasive. This article provides an overview of emerging transcatheter mitral valve replacement (TMVR) options currently available and summarises challenges in device design and patient selection and also early results.
二尖瓣反流(MR)是西方世界第二大常见的瓣膜性心脏病,仅在美国就有两到四百万患者。MR 随年龄增长而增加,因此,随着欧洲和美国预期寿命的增加,MR 负担预计将会增加。医学和手术治疗一直是治疗的基石,因为未经治疗的 MR 会导致预后不良。然而,由于风险高,只有少数患者接受手术治疗。随着经导管主动脉瓣植入术(TAVI)的成功,许多经导管治疗选择已经出现,为这些患者提供了一种侵入性较小的选择。一方面,修复选择似乎侵入性较小,但往往会降低 MR,另一方面,置换选择可以消除 MR,但可能更具侵入性。本文概述了目前可用的新兴经导管二尖瓣置换术(TMVR)选择,并总结了设备设计和患者选择方面的挑战,以及早期结果。