Giannini Francesco, Colombo Antonio
Cardiovascular Interventions Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Eur Heart J Suppl. 2019 Mar;21(Suppl B):B43-B47. doi: 10.1093/eurheartj/suz031. Epub 2019 Mar 29.
The renewed interest in tricuspid valve pathology is a consequence of the high mortality rate associated with this valve dysfunction, mostly functional, and secondary to left ventricular impairment, or pulmonary hypertension. Despite the clear relationship between tricuspid insufficiency and mortality, surgical treatment is offered to a small group of patients, due to the significant in-hospital mortality secondary also to the multiple comorbidities and the advanced stage of left ventricular dysfunction. During the last few years, new therapeutic options have been developed for the percutaneous treatment of tricuspid insufficiency which, albeit still in the experimental phase, provides an alternative to surgery in patients at very high-risk or frankly inoperable. We will describe the various percutaneous therapeutic options available today, and their potential application to clinical practice.
对三尖瓣病理学重新产生兴趣是由于与这种瓣膜功能障碍相关的高死亡率,这种功能障碍大多是功能性的,继发于左心室损害或肺动脉高压。尽管三尖瓣关闭不全与死亡率之间存在明确关系,但由于多种合并症以及左心室功能障碍的晚期阶段导致的显著院内死亡率,只有一小部分患者接受手术治疗。在过去几年中,已经开发出用于经皮治疗三尖瓣关闭不全的新治疗选择,尽管仍处于实验阶段,但为极高风险或明显无法手术的患者提供了手术之外的替代方案。我们将描述目前可用的各种经皮治疗选择及其在临床实践中的潜在应用。