Garcia-Sayan Enrique, Chen Tiffany, Khalique Omar K
Division of Cardiology, University of Texas Health Science Center at Houston, Houston, TX, United States.
Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
Front Cardiovasc Med. 2021 Feb 22;8:582925. doi: 10.3389/fcvm.2021.582925. eCollection 2021.
Transcatheter mitral valve interventions are an evolving and growing field in which multimodality cardiac imaging is essential for diagnosis, procedural planning, and intraprocedural guidance. Currently, transcatheter mitral valve-in-valve with a balloon-expandable valve is the only form of transcatheter mitral valve replacement (TMVR) approved by the FDA, but valve-in-ring and valve-in-mitral annular calcification interventions are increasingly being performed. Additionally, there are several devices under investigation for implantation in a native annulus. Paravalvular leak (PVL) is a known complication of surgical or transcatheter valve implantation, where regurgitant flow occurs between the prosthetic sewing ring and the native mitral annulus. We sought to describe the role and applications of multimodality cardiac imaging for TMVR, and PVL closure, including the use of Cardiovascular Computed Tomography Angiography and 3-Dimensional Transesophageal Echocardiography for diagnosis, prosthetic valve evaluation, pre-procedural planning, and intraprocedural guidance, as well as evolving technologies such as fusion imaging and 3D printing.
经导管二尖瓣介入治疗是一个不断发展且日益壮大的领域，在该领域中，多模态心脏成像对于诊断、手术规划和术中引导至关重要。目前，经导管二尖瓣瓣中瓣置入术（使用球囊扩张瓣膜）是美国食品药品监督管理局（FDA）批准的唯一一种经导管二尖瓣置换术（TMVR）形式，但瓣中瓣环置入术和二尖瓣瓣环钙化介入治疗的开展越来越多。此外，有几种器械正在研究用于植入天然瓣环。瓣周漏（PVL）是外科手术或经导管瓣膜植入术已知的并发症，即人工瓣膜缝合环与天然二尖瓣瓣环之间出现反流。我们试图描述多模态心脏成像在TMVR及PVL封堵中的作用和应用，包括使用心血管计算机断层扫描血管造影术和三维经食管超声心动图进行诊断、人工瓣膜评估、术前规划和术中引导，以及融合成像和3D打印等不断发展的技术。
