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经导管三尖瓣介入治疗:现状、挑战与未来方向。

Transcatheter Tricuspid Valve Interventions: Landscape, Challenges, and Future Directions.

机构信息

Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.

Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

出版信息

J Am Coll Cardiol. 2018 Jun 26;71(25):2935-2956. doi: 10.1016/j.jacc.2018.04.031.

Abstract

Tricuspid regurgitation is a common finding in patients with left-sided valvular or myocardial disease, often being a marker for late-stage chronic heart failure with a grim prognosis. However, isolated tricuspid valve surgery remains infrequent and is associated with the highest mortality among all valve procedures. Hence, a largely unmet clinical need exists for less invasive therapeutic options in these patients. In recent times, multiple percutaneous therapies have been developed for treating severe tricuspid regurgitation, including tricuspid valve repair and, more recently replacement, opening an entirely new venue for managing tricuspid regurgitation. The aim of this review is to provide an updated overview and a clinical perspective on novel transcatheter tricuspid valve therapies, highlighting potential challenges and future directions.

摘要

三尖瓣反流是左心瓣膜或心肌疾病患者的常见表现,常提示晚期慢性心力衰竭,预后不良。然而,孤立的三尖瓣手术仍然很少见,并且与所有瓣膜手术中死亡率最高相关。因此,这些患者需要更微创的治疗选择,但目前这一需求尚未得到满足。近年来,已经开发出多种经皮治疗方法来治疗严重的三尖瓣反流,包括三尖瓣修复,以及最近的三尖瓣置换,为治疗三尖瓣反流开辟了全新的途径。本文旨在提供经导管三尖瓣瓣膜治疗的最新概述和临床观点,重点介绍潜在的挑战和未来方向。

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