Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.
Centre of Cardiology and Angiology, Department of Cardiovascular Diseases, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania.
Expert Rev Cardiovasc Ther. 2021 Sep;19(9):817-824. doi: 10.1080/14779072.2021.1865154. Epub 2020 Dec 28.
: Tricuspid valve (TV) dysfunction treatment experiences exponential growth of the interest over the last years. New techniques for percutaneous tricuspid valve treatment are either on the market or in the early stages of development.: Deficiency of uniform guideline-based recommendations leads to diverse TV dysfunction treatment options. The current review describes the development of surgical techniques for TV dysfunction in Ebstein's anomaly and transition to a variety of new technologies. Then, the focus is on the potential of percutaneous interventions to reduce the total number of open-heart surgeries in patients with congenital heart disease (CHD) after TV replacement with a bioprosthesis to improve TV function.: TV dysfunction is usually a complex combination of anatomical cardiac features in CHD. Compared to adults with secondary TV dysfunction, CHD patients usually are younger and have experienced several open-heart surgeries at a young age. Therefore, TV dysfunction can affect long-term life expectancy and quality of life significantly. So far, surgery was the gold standard for TV dysfunction treatment. The duration of TV plasty or bioprosthesis is limited, while the risk of re-do operations increases with every procedure. Percutaneous TV implantation may reduce the total number of open-heart surgeries over a patient's life.
: 近年来,三尖瓣(TV)功能障碍的治疗经验呈指数级增长。经皮三尖瓣治疗新技术要么已经上市,要么处于早期开发阶段。: 缺乏基于统一指南的建议导致了不同的 TV 功能障碍治疗选择。本综述描述了 Ebstein 畸形中 TV 功能障碍的手术技术的发展,并逐步转向各种新技术。然后,重点介绍了经皮介入技术在改善 TV 功能后减少 CHD 患者 TV 生物瓣置换后心脏直视手术总数的潜力。: TV 功能障碍通常是 CHD 中解剖心脏特征的复杂组合。与继发 TV 功能障碍的成年人相比,CHD 患者通常更年轻,并且在年轻时已经经历了多次心脏直视手术。因此,TV 功能障碍会显著影响长期预期寿命和生活质量。到目前为止,手术一直是 TV 功能障碍治疗的金标准。TV 成形术或生物瓣的持续时间有限,而每次手术都会增加再次手术的风险。经皮 TV 植入术可能会减少患者一生中的心脏直视手术总数。