Montenegro da Costa Márcio José, Quintella Edgard Freitas, Kohn Luiz, Lacoste Maximiliano Otero, Leite Gustavo Lycurgo, Hadid Leonardo, Kruczan Dany David, Zajdenverg Ricardo, de Castro Sabino Hugo, da Motta Paulo Antônio Marra
Instituto Estadual de Cardiologia Aloysio de Castro, Rua Davi Campista, 326, Rio de Janeiro 22261-010, Brazil.
Hospital Universitário Pedro Ernesto, Boulevard 28 de Setembro, 77, Rio de Janeiro 20551-030, Brazil.
J Clin Med. 2021 Sep 4;10(17):4004. doi: 10.3390/jcm10174004.
Severe tricuspid commitment is no longer understood as merely a marker of disease but is now widely thought of as a significant contributor to cardiac morbidity and mortality. However, isolated tricuspid valve surgery remains rare and to this day continues to be associated with the highest surgical risk among all valve procedures and high operative mortality rates, especially in reoperations. Therefore, the development of tricuspid transcatheter procedures is as necessary as it was for the other valves a couple of years ago. Recently, multiple percutaneous therapies have been developed for the management of severe tricuspid disease, initially only repair and more recently replacement, thus creating a new branch for the management of patients who have already undergone surgery and who present with dysfunctional bioprostheses. The purpose of this review and report is to demonstrate current and possible future challenges, and to show that the valve-in-valve procedure of the tricuspid valve is feasible and safe, and now can be performed in all its range, in the smallest to the largest sizes of presentation, without incurring the untoward risks of conventional surgery.
严重三尖瓣病变不再仅仅被视为疾病的一个标志，如今人们普遍认为它是导致心脏发病和死亡的一个重要因素。然而，单纯三尖瓣手术仍然很少见，直至今日，在所有瓣膜手术中，它仍与最高的手术风险以及高手术死亡率相关，尤其是在再次手术时。因此，三尖瓣经导管手术的发展与几年前其他瓣膜手术的发展一样必要。最近，已经开发出多种经皮治疗方法来处理严重三尖瓣疾病，最初只有修复方法，最近又有了置换方法，从而为那些已经接受过手术且出现生物瓣膜功能障碍的患者的治疗开创了一个新的领域。本综述和报告的目的是展示当前及未来可能面临的挑战，并表明三尖瓣瓣中瓣手术是可行且安全的，现在可以在各种情况下进行，无论病变大小，都不会带来传统手术的不良风险。
