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经导管三尖瓣修复和置换术:三尖瓣反流治疗的当前技术和器械的全景综述。

Transcatheter tricuspid valve repair and replacement: a landscape review of current techniques and devices for the treatment of tricuspid valve regurgitation.

机构信息

Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

出版信息

Expert Rev Cardiovasc Ther. 2021 May;19(5):399-411. doi: 10.1080/14779072.2021.1915133. Epub 2021 Apr 26.

Abstract

Background and ObjectiveTricuspid regurgitation is a prevalent and undertreated cardiac pathology impacting millions across the globe. While historically surgical interventions for isolated tricuspid regurgitation were largely avoided due to data citing poor surgical outcomes, advances in transcatheter techniques and imaging modalities have reframed the approach to tricuspid valve disease in promising new ways.MethodsHere we sought to provide a landscape review of the current state of the field for transcatheter tricuspid valve interventions. We first start with a descriptive overview of the tricuspid valve, reviewing the anatomy, imaging characteristics, and the current guidelines for tricuspid interventions. We then review both transcatheter valve repair and valve replacement modalities, highlighting the devices, techniques, and valves currently under investigation, summarizing available outcomes data for each modality when possible.Results and ConclusionOur aim in writing this landscape review is the create an all-encompassing, up-to-date resource for clinicians to refer to when seeking to learn about the current state of transcatheter tricuspid valve interventions. We also hope to highlight the exciting promise of transcatheter tricuspid valve replacement in appropriate patients, and review the valves currently under development for use in the tricuspid position.

摘要

背景与目的

三尖瓣反流是一种普遍存在且治疗不足的心脏病理学问题,影响着全球数百万人。尽管历史上由于数据显示手术结果不佳,手术干预孤立性三尖瓣反流的情况基本被避免,但经导管技术和成像方式的进步以新的方式重新定义了三尖瓣疾病的治疗方法。

方法

在这里,我们旨在对经导管三尖瓣瓣膜介入治疗的现状进行全面综述。我们首先对三尖瓣进行描述性概述,回顾三尖瓣的解剖结构、影像学特征以及三尖瓣介入治疗的当前指南。然后我们回顾了经导管瓣膜修复和瓣膜置换两种方式,重点介绍了目前正在研究的器械、技术和瓣膜,总结了每种方式的可用结果数据。

结果和结论

我们撰写本综述的目的是为临床医生提供一个全面、最新的资源,以帮助他们了解经导管三尖瓣瓣膜介入治疗的现状。我们还希望强调经导管三尖瓣置换在合适患者中的令人兴奋的应用前景,并回顾目前正在开发用于三尖瓣位置的瓣膜。

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