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经导管二尖瓣手术剖析

Anatomy of a Transcatheter Mitral Valve Service.

作者信息

Gill Harminder, Adams Heath S L, Chehab Omar, Allen Christopher, Hancock Jane, Lamata Pablo, Lucchese Gianluca, Prendergast Bernard, Redwood Simon, Patterson Tiffany, Rajani Ronak

机构信息

Cardiovascuar Directorate, Guy's and St Thomas' Hospitals, London, United Kingdom.

School of Biomedical Engineering and Imaging Sciences Engineering, King's College London, London, United Kingdom.

出版信息

Front Cardiovasc Med. 2022 Apr 15;9:862471. doi: 10.3389/fcvm.2022.862471. eCollection 2022.

DOI:10.3389/fcvm.2022.862471
PMID:35497993
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9051038/
Abstract

Transcatheter mitral therapies offer treatment options to selected patients who are unable to undergo open procedures due to prohibitive surgical risk. Data detailing the design and structure of transcatheter mitral services to ensure appropriate patient selection and tailored management strategies is lacking. We report our initial experience of developing and running a purpose-built transcatheter mitral service. The nature and number of referral sources, the multi-disciplinary make-up of the dedicated Mitral Heart Team and the use of integrative imaging assessment with incorporation of computational solutions are discussed. In addition, a summary of the clinical decision-making process is presented. This report sets out a framework from which future clinics can evolve to improve and streamline the delivery of transcatheter mitral therapies.

摘要

经导管二尖瓣治疗为因手术风险过高而无法接受开放性手术的特定患者提供了治疗选择。目前缺乏详细描述经导管二尖瓣治疗服务的设计和结构，以确保合适的患者选择和定制化管理策略的数据。我们报告了我们开发和运营专门的经导管二尖瓣治疗服务的初步经验。讨论了转诊来源的性质和数量、专门的二尖瓣心脏团队的多学科组成以及结合计算解决方案的综合成像评估的使用。此外，还介绍了临床决策过程的总结。本报告提出了一个框架，未来的诊所可以据此发展，以改进和简化经导管二尖瓣治疗的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/e1c2c0eaa154/fcvm-09-862471-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/2a2671540310/fcvm-09-862471-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/51f4907fc51c/fcvm-09-862471-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/7b89796cc76c/fcvm-09-862471-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/e1c2c0eaa154/fcvm-09-862471-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/2a2671540310/fcvm-09-862471-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/51f4907fc51c/fcvm-09-862471-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/7b89796cc76c/fcvm-09-862471-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae57/9051038/e1c2c0eaa154/fcvm-09-862471-g0004.jpg

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引用本文的文献

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Front Cardiovasc Med. 2023 Jul 21;10:1101337. doi: 10.3389/fcvm.2023.1101337. eCollection 2023.

本文引用的文献

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Corrigendum to: 2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).勘误：《2021 ESC/EACTS 心脏瓣膜病管理指南》：由欧洲心脏病学会（ESC）心脏瓣膜病管理特别工作组和欧洲心胸外科学会（EACTS）制定。
Eur Heart J. 2022 Jun 1;43(21):2022. doi: 10.1093/eurheartj/ehac051.
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Transcatheter Mitral Valve Therapy in the United States: A Report From the STS-ACC TVT Registry.经导管二尖瓣治疗在美国：来自 STS-ACC TVT 注册中心的报告。
J Am Coll Cardiol. 2021 Dec 7;78(23):2326-2353. doi: 10.1016/j.jacc.2021.07.058. Epub 2021 Oct 25.
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Impact of Surgical and Transcatheter Aortic Valve Replacement on Frailty Score.外科手术和经导管主动脉瓣置换对虚弱评分的影响。
Heart Lung Circ. 2022 Apr;31(4):566-574. doi: 10.1016/j.hlc.2021.09.014. Epub 2021 Oct 14.
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Mitral Regurgitation International Database (MIDA) Score Predicts Outcome in Patients With Heart Failure Undergoing Transcatheter Edge-to-Edge Mitral Valve Repair.二尖瓣反流国际数据库（MIDA）评分预测行经皮缘对缘二尖瓣修复术心力衰竭患者的结局。
J Am Heart Assoc. 2021 Jul 6;10(13):e019548. doi: 10.1161/JAHA.120.019548. Epub 2021 Jun 30.
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Centre procedural volume and adverse in-hospital outcomes in patients undergoing percutaneous transvenous edge-to-edge mitral valve repair using MitraClip® in Germany.德国经皮经导管缘对缘二尖瓣修复术（MitraClip）治疗患者的中心手术量与院内不良转归。
Eur J Heart Fail. 2021 Aug;23(8):1380-1389. doi: 10.1002/ejhf.2162. Epub 2021 May 3.
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The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC.心力衰竭患者继发性二尖瓣反流的管理：欧洲心脏病学会心力衰竭协会（HFA）、欧洲心血管影像协会（EACVI）、欧洲心脏节律协会（EHRA）和欧洲经皮心血管介入协会（EAPCI）的联合立场声明
Eur Heart J. 2021 Mar 31;42(13):1254-1269. doi: 10.1093/eurheartj/ehab086.
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Predictors and prognostic relevance of tricuspid alterations in patients undergoing transcatheter edge-to-edge mitral valve repair.行经皮缘对缘二尖瓣修复术患者三尖瓣改变的预测因子及预后相关性。
EuroIntervention. 2021 Nov 19;17(10):827-834. doi: 10.4244/EIJ-D-20-01094.
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Impact of Tricuspid Regurgitation on Clinical Outcomes: The COAPT Trial.三尖瓣反流对临床结局的影响：COAPT 试验。
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Risk modeling in transcatheter aortic valve replacement remains unsolved: an external validation study in 2946 German patients.经导管主动脉瓣置换术的风险建模仍未解决：2946 例德国患者的外部验证研究。
Clin Res Cardiol. 2021 Mar;110(3):368-376. doi: 10.1007/s00392-020-01731-9. Epub 2020 Aug 26.
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