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经导管二尖瓣修复与置换术:未来前景如何?

Transcatheter Mitral Valve Repair and Replacement: What's on the Horizon?

机构信息

Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.

Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.

出版信息

Semin Thorac Cardiovasc Surg. 2021 Summer;33(2):291-298. doi: 10.1053/j.semtcvs.2020.09.018. Epub 2020 Sep 24.

Abstract

There are more than 4 million people affected by mitral regurgitation in both the United States and Europe. Prior to the last decade the only options for treatment of MR were medical therapy and open-heart surgery which left many high risk patients with little option once medically optimized. However, we saw a flood in innovative transcatheter mitral valve interventions. As the technologies are refined these new approaches are considerably less invasive and for some high-risk patients may represent a superior option to conventional open-heart surgery. There are 3 main approaches currently being considered for transcatheter mitral valve repair, edge to edge repair, indirect annuloplasty and direct annuloplasty. There have also been large advancements in recent years in transcatheter replacement of the mitral valve. Although many of these devices are under investigation still, we sought to examine the current state of innovative transcatheter mitral valve technologies.

摘要

在美国和欧洲,有超过 400 万人受到二尖瓣反流的影响。在过去十年之前,治疗 MR 的唯一选择是药物治疗和心脏直视手术,这使得许多高危患者在经过药物优化后几乎没有选择。然而,我们看到了大量创新性的经导管二尖瓣瓣膜介入治疗方法的涌现。随着技术的不断完善,这些新方法的侵入性大大降低,对于一些高危患者来说,可能代表着优于传统心脏直视手术的选择。目前,经导管二尖瓣瓣环修复有 3 种主要方法,即瓣对瓣修复、间接瓣环成形术和直接瓣环成形术。近年来,经导管二尖瓣置换术也取得了重大进展。尽管这些设备中的许多仍在研究中,但我们仍试图探讨创新性经导管二尖瓣瓣膜技术的现状。

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