Santaló-Corcoy Marcel, Asmarats Lluís, Li Chi-Hion, Arzamendi Dabit
Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Division of Cardiac Imaging, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Ann Transl Med. 2020 Aug;8(15):964. doi: 10.21037/atm.2020.03.219.
Tricuspid regurgitation is a highly prevalent condition, with detrimental effects on long-term survival. However, it has been historically neglected, and only surgically addressed when symptomatic diuretic agents proved insufficient to alleviate congestion. Besides, mortality rates of isolated tricuspid regurgitation surgery have been persistently high, even in contemporary series. This has led to the advent of a myriad of transcatheter tricuspid valve interventions mimicking current surgical technologies, for which a comprehensive imaging work-up holds the key for proper patient selection and intraprocedural monitoring. Although initially designed for compassionate use patients, growing experience and encouraging results of these less-invasive technologies are broadening the spectrum of beneficiaries. In this review, we will focus on the current picture of transcatheter tricuspid valve interventions, with special interest on the current understanding of pathoanatomic tricuspid regurgitation progression, preprocedural multimodality imaging and the latest experience on the different transcatheter devices.
三尖瓣反流是一种非常常见的病症，对长期生存有不利影响。然而，它在历史上一直被忽视，只有在症状性利尿剂被证明不足以缓解充血时才进行手术治疗。此外，即使在当代系列研究中，单纯三尖瓣反流手术的死亡率也一直居高不下。这导致了无数模仿当前手术技术的经导管三尖瓣介入治疗的出现，而全面的影像学检查对于正确选择患者和术中监测至关重要。尽管这些侵入性较小的技术最初是为同情使用患者设计的，但不断增长的经验和令人鼓舞的结果正在扩大受益范围。在这篇综述中，我们将重点关注经导管三尖瓣介入治疗的现状，特别关注对病理解剖学三尖瓣反流进展的当前认识、术前多模态成像以及不同经导管装置的最新经验。
