Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany.
Expert Rev Med Devices. 2023 Feb;20(2):99-108. doi: 10.1080/17434440.2022.2098013. Epub 2022 Jul 20.
Mitral regurgitation (MR) is associated with substantial morbidity and mortality. Within the past 15 years, mitral valve edge-to-edge repair (M-TEER) has developed from an experimental approach to a guideline-recommended, safe, and effective treatment option for patients with severe primary or secondary mitral regurgitation.
This review covered relevant publications of M-TEER and summarizes the development of M-TEER devices within the last 15 years. It outlines anatomical challenges which drove the evolution of M-TEER devices, provides an overview about the current state of clinical application and research, and offers an outlook into the future of transcatheter mitral valve treatment.
The development and refinement of new M-TEER device generations offer the possibility to treat a wide range of mitral valve anatomies. Choosing the best device for the individual anatomic properties of the patients and considering comorbidities is the key to maximized MR reduction, minimalized complication rates, and thus optimized postinterventional prognosis. Independent from prognostic implications, quality of life has become an important patient-centered outcome that can be improved by M-TEER in virtually all patients treated.
二尖瓣反流(MR)与大量发病率和死亡率相关。在过去的 15 年中,二尖瓣瓣环成形术(M-TEER)已从一种实验方法发展为指南推荐的、安全有效的治疗严重原发性或继发性二尖瓣反流的方法。
本文综述了 M-TEER 的相关文献,并总结了过去 15 年来 M-TEER 器械的发展。本文概述了推动 M-TEER 器械发展的解剖学挑战,概述了当前临床应用和研究的现状,并展望了经导管二尖瓣治疗的未来。
新型 M-TEER 器械的开发和改进为治疗各种二尖瓣解剖结构提供了可能。选择最适合患者个体解剖特征并考虑合并症的器械是最大限度降低 MR、最小化并发症发生率以及优化介入后预后的关键。独立于预后意义,生活质量已成为一个重要的以患者为中心的结果,几乎所有接受治疗的患者都可以通过 M-TEER 得到改善。