Vahanian Alec, Brochet Eric, Juliard Jean-Michel
Department of Cardiology, Bichat hospital, University Paris VII, Paris, France.
Front Cardiovasc Med. 2018 Apr 12;5:37. doi: 10.3389/fcvm.2018.00037. eCollection 2018.
Tricuspid regurgitation (TR) is an important clinical problem because it is frequent and carries a poor prognosis when it is left uncorrected. However, there is still a lack of awareness of tricuspid disease in the medical community. The indications for evaluation and surgical interventions in patients with TR were recently updated in the ESC/EACTS guidelines. Transcatheter tricuspid valve intervention (TTVI), almost exclusively valve repair, is at an early stage of development as only a few hundreds of patients have been treated. The first-in-man valve implantation was very recently performed. The recent ESC/EACTS Guidelines state that "The potential role of transcatheter tricuspid valve treatment in high-risk patients needs to be determined". We shall review here which lessons of interest for TTVI can be learned from the Guidelines as regards evaluation and indications for surgery and try to imagine what could be the place of TTVI in the Guidelines in the future.
三尖瓣反流(TR)是一个重要的临床问题,因为它很常见,若不加以纠正,预后较差。然而,医学界对三尖瓣疾病仍缺乏认识。ESC/EACTS指南最近更新了TR患者评估和手术干预的指征。经导管三尖瓣介入治疗(TTVI),几乎全是瓣膜修复,尚处于发展早期,因为仅治疗了数百例患者。首例人体瓣膜植入术最近刚刚完成。最新的ESC/EACTS指南指出,“经导管三尖瓣治疗在高危患者中的潜在作用有待确定”。在此,我们将回顾从该指南中可以学到哪些关于TTVI在评估和手术指征方面的有趣经验,并尝试设想未来TTVI在指南中的地位。