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经导管瓣膜介入治疗心力衰竭:旧问新解。

Transcatheter valve interventions in heart failure: new answers to old questions.

机构信息

Department of Internal Medicine and Cardiology, Department of Cardiology, Campus Virchow Klinikum (CVK), Charité - Universitätsmedizin Berlin, Augustenburgerplatz 1, 13353, Berlin, Germany.

Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Viale della Resistenza 23, 20036, Meda, Italy.

出版信息

Heart Fail Rev. 2018 Nov;23(6):859-870. doi: 10.1007/s10741-018-9701-4.

Abstract

Heart failure (HF) is often associated with different valve diseases, predominantly functional mitral and tricuspid regurgitation. However, the association between HF and aortic stenosis, particularly low-flow low-gradient aortic stenosis, is not infrequent. Severe mitral and tricuspid regurgitations, as well as aortic stenosis, in HF patients worsen prognosis and left ventricular dilatation and induce further reduction in left ventricular ejection fraction. Transcatheter edge-to-edge mitral and tricuspid valve repair and transcatheter aortic valve implantation could be an important therapeutic option with a satisfactory long-term outcome in HF patients with comorbidities and even in patients with severely depressed ejection fraction.

摘要

心力衰竭(HF)常与不同的瓣膜疾病相关,主要为功能性二尖瓣和三尖瓣反流。然而,HF 与主动脉瓣狭窄,特别是低流量低梯度主动脉瓣狭窄的关联并不少见。HF 患者的严重二尖瓣和三尖瓣反流以及主动脉瓣狭窄会使预后恶化,导致左心室扩张,并进一步降低左心室射血分数。对于合并症的 HF 患者,甚至对于射血分数严重降低的患者,经导管缘对缘二尖瓣和三尖瓣修复术以及经导管主动脉瓣植入术可能是一种重要的治疗选择,具有满意的长期疗效。

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