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经导管二尖瓣治疗:定义获益患者。

Transcatheter Mitral Valve Therapy: Defining the Patient Who Will Benefit.

机构信息

Center for Structural Heart Disease, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202, USA.

出版信息

Curr Cardiol Rep. 2018 Sep 12;20(11):107. doi: 10.1007/s11886-018-1058-8.

Abstract

PURPOSE OF REVIEW

This report aims to define the clinical and anatomic variables key in determining patient suitability for transcatheter mitral valve therapies.

RECENT FINDINGS

Candidacy for transcatheter mitral valve repair requires weighing the clinical variables that may impact the ability to improve patient symptoms and prolong survival that include left ventricular ejection fraction, symptom severity, pulmonary hypertension, and magnitude of residual regurgitation or stenosis. Individualized selection of transcatheter repair or replacement based on patho-anatomy is being explored. The primary goal is achieving significant reduction in mitral regurgitation. Transcatheter mitral valve replacement requires rigorous anatomic screening using computed tomography and candidates should be able to take oral anticoagulation. Selection of patients for transcatheter mitral valve repair is complex and requires intimate knowledge of clinical variables and specific device limitations.

摘要

目的综述

本报告旨在确定决定患者经导管二尖瓣治疗适用性的临床和解剖变量。

最新发现

经导管二尖瓣修复的适应证需要权衡可能影响改善患者症状和延长生存能力的临床变量,包括左心室射血分数、症状严重程度、肺动脉高压以及残余反流或狭窄的程度。正在探索基于病理解剖的经导管修复或置换的个体化选择。主要目标是实现显著降低二尖瓣反流。经导管二尖瓣置换需要使用计算机断层扫描进行严格的解剖筛查,且候选者应能够服用口服抗凝药物。经导管二尖瓣修复患者的选择较为复杂,需要深入了解临床变量和特定器械的局限性。

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