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二尖瓣反流的介入治疗:手术的替代方案?

Interventional treatment of mitral valve regurgitation: an alternative to surgery?

作者信息

Praz Fabien, Brugger Nicolas, Kassar Mohammad, Hunziker Lukas, Moschovitis Aris, Stortecky Stefan, Reineke David, Pilgrim Thomas, Windecker Stephan

机构信息

Department of Cardiology, Bern University Hospital, Bern, Switzerland.

Department of Cardiac Surgery, Bern University Hospital, Bern, Switzerland.

出版信息

Swiss Med Wkly. 2019 Mar 10;149:w20023. doi: 10.4414/smw.2019.20023. eCollection 2019 Feb 25.

Abstract

Mitral regurgitation is a highly prevalent condition among elderly patients, affecting almost 10% of the general population aged 75 and older. Left untreated, severe mitral regurgitation results in high mortality and frequent hospitalisation for treatment of heart failure. Surgical treatment remains the first-line therapy for symptomatic, severe mitral regurgitation , especially for patients presenting with a primary aetiology. However, a high proportion of patients with mitral regurgitation are turned down for open-heart surgery, mainly due to advanced age, diminished left ventricular function and comorbidities. Thus, percutaneous treatment options have been recently developed as an alternative. In this article, we will review transcatheter interventional techniques at the level of the mitral valve, including implantation technique, indications and clinical results.

摘要

二尖瓣反流在老年患者中极为常见,影响着近10%的75岁及以上普通人群。若不治疗,严重二尖瓣反流会导致高死亡率以及因心力衰竭治疗而频繁住院。手术治疗仍是有症状的严重二尖瓣反流的一线治疗方法,尤其是对于有原发性病因的患者。然而,相当一部分二尖瓣反流患者因高龄、左心室功能减退和合并症而被拒绝接受心脏直视手术。因此,经皮治疗方案最近已被开发出来作为替代方案。在本文中,我们将回顾二尖瓣水平的经导管介入技术,包括植入技术、适应证和临床结果。

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