Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Can J Cardiol. 2018 Sep;34(9):1200-1209. doi: 10.1016/j.cjca.2018.04.034. Epub 2018 Jul 12.
Chronic mitral regurgitation (MR) remains a common cardiovascular condition resulting in significant morbidity and mortality. With an aging population, increasing trends for both primary (degenerative) and secondary (functional) MR have become apparent. Although the gold standard remains surgical intervention with mitral valve repair/replacement, comorbid conditions have steered the development of less invasive technologies to mitigate perioperative surgical risk. Transcatheter mitral valve repair using a percutaneous edge-to-edge technique is the most widely available choice at present. However, other transcatheter mitral valve repair techniques such as annuloplasty and chordal implantation are notable alternatives. Moreover, emerging technologies in transcatheter mitral valve replacement are rapidly establishing their roles in the field of chronic severe MR therapy. Hence, it is imperative to understand the indications and limitations of these various transcatheter mitral valve interventions to provide the best and most up-to-date clinical care for patients. This review will outline current evidence and patient selection criteria for such device-based therapies.
慢性二尖瓣反流（MR）仍然是一种常见的心血管疾病，导致发病率和死亡率显著增加。随着人口老龄化，原发性（退行性）和继发性（功能性）MR 的发病率均呈上升趋势。尽管二尖瓣修复/置换手术仍然是金标准，但合并症的存在促使人们开发了创伤更小的技术来降低围手术期的手术风险。目前，经皮缘对缘修复技术是应用最广泛的经导管二尖瓣修复方法。然而，其他经导管二尖瓣修复技术，如瓣环成形术和腱索植入术，也是值得注意的替代方法。此外，经导管二尖瓣置换术的新兴技术也在慢性重度 MR 治疗领域迅速确立其地位。因此，了解这些不同的经导管二尖瓣介入治疗的适应证和局限性对于为患者提供最佳和最新的临床治疗至关重要。本综述将概述这些基于器械的治疗方法的现有证据和患者选择标准。
