Eicken Andreas, Ewert Peter
Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Technische Universität Munich, Munich, Germany.
Cardiovasc Diagn Ther. 2018 Dec;8(6):765-770. doi: 10.21037/cdt.2018.09.08.
Severe tricuspid valve (TV) dysfunction in patients with congenital heart disease (CHD) is usually treated by open heart surgery in relatively young patients. If a valve plasty is not possible, a biological valve is implanted with a limited durability. Due to valve degeneration repeated valve exchanges are necessary in these patients. To expand the lifetime of a bioprosthesis in tricuspid position percutaneous TV implantation (PTVI) was introduced recently. PTVI is a promising new catheter interventional technology. The current review summarizes the indication for PTVI, describes the procedure itself and gives an outlook on medium to long-term results of this catheter intervention. PTVI in patients with severe TV dysfunction is less invasive, safe and effective, if performed by an experienced operator, and may help to reduce the total number of open-heart surgeries during a patient's life time. However, further studies with larger patient numbers and longer follow-up are needed.
先天性心脏病(CHD)患者的严重三尖瓣(TV)功能障碍通常在相对年轻的患者中通过心脏直视手术进行治疗。如果瓣膜成形术不可行,则植入生物瓣膜,但其耐久性有限。由于瓣膜退变,这些患者需要反复进行瓣膜置换。为了延长三尖瓣位生物假体的使用寿命,经皮三尖瓣植入术(PTVI)最近被引入。PTVI是一种有前景的新型导管介入技术。本综述总结了PTVI的适应证,描述了该手术本身,并对这种导管介入的中长期结果进行了展望。对于严重TV功能障碍的患者,PTVI侵入性较小、安全且有效,如果由经验丰富的操作者进行,可能有助于减少患者一生中心脏直视手术的总数。然而,需要进行更大规模患者数量和更长随访时间的进一步研究。