Burke Lucas, Hassanin Magdi, Ong Geraldine, Fam Neil
St. Michael's Hospital, Toronto, ON, Canada.
Front Cardiovasc Med. 2021 Oct 13;8:706123. doi: 10.3389/fcvm.2021.706123. eCollection 2021.
Concomitant tricuspid regurgitation (TR) is common in patients with mitral regurgitation (MR). While current guidelines recommend repair of both valves at the time of surgery when feasible, high risk patients are often undertreated, leading to significant morbidity and mortality. With advances in transcatheter edge-to-edge repair (TEER) devices and technique, combined TEER for treating significant MR and TR has emerged as a new tool for heart failure management. Recent evidence has shed light on which patients with severe TR should be targeted for transcatheter intervention either in isolation or in combination with a MV TEER procedure and allows for expanded treatment options in patients who otherwise would be limited to medical management. Technological advancements remain ahead of robust clinical data, and thus randomized clinical studies in patients with severe MR and TR will be instrumental in determining the best approach in treating these patients with transcatheter therapies.
二尖瓣反流（MR）患者常合并三尖瓣反流（TR）。虽然当前指南建议在可行的情况下，手术时对两个瓣膜进行修复，但高危患者往往治疗不足，导致显著的发病率和死亡率。随着经导管缘对缘修复（TEER）装置和技术的进步，联合TEER治疗重度MR和TR已成为心力衰竭管理的一种新工具。最近的证据揭示了哪些重度TR患者应单独或与二尖瓣TEER手术联合进行经导管干预，为那些原本只能接受药物治疗的患者提供了更多的治疗选择。技术进步仍领先于有力的临床数据，因此，针对重度MR和TR患者的随机临床研究，将有助于确定经导管治疗这些患者的最佳方法。
