Scott Erik J, Rotar Evan P, Charles Eric J, Lim D Scott, Ailawadi Gorav
Division of Cardiac Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
Division of Cardiology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA.
Ann Cardiothorac Surg. 2021 Jan;10(1):75-84. doi: 10.21037/acs-2020-mv-217.
Surgical mitral valve intervention for severe functional, or secondary mitral regurgitation is a viable option for patients deemed to be operative candidates and can be performed via traditional sternotomy or by minimally invasive techniques with similar outcomes. Transcatheter mitral valve replacement is an emerging technology with a potential role in the treatment of functional mitral valve regurgitation. A plethora of devices are currently in development and in various stages of clinical investigation. Operative approach to transcatheter mitral valve replacement varies from a percutaneous transseptal approach to a hybrid percutaneous/surgical apical approach. The Tendyne, Intrepid and Evoque systems show promising results from their early feasibility studies in treatment of patients with mitral regurgitation that were too high risk for surgery. In this review, we describe considerations for surgical and transcatheter mitral valve replacement for functional mitral valve regurgitation.
对于被认为适合手术的患者，手术治疗重度功能性或继发性二尖瓣反流是一种可行的选择，可通过传统胸骨切开术或微创技术进行，且结果相似。经导管二尖瓣置换术是一项新兴技术，在功能性二尖瓣反流的治疗中具有潜在作用。目前有大量设备正在研发中，处于临床研究的不同阶段。经导管二尖瓣置换术的手术方法从经皮经间隔途径到经皮/外科联合心尖途径不等。Tendyne、Intrepid和Evoque系统在治疗手术风险过高的二尖瓣反流患者的早期可行性研究中显示出了有前景的结果。在本综述中，我们描述了功能性二尖瓣反流的外科和经导管二尖瓣置换的相关考量。
