Division of Cardiology, Banner University Medical Center, Phoenix, AZ, USA.
Department of Cardiovascular Medicine, Beaumont Hospital, Royal Oak, MI, USA.
Curr Cardiol Rep. 2022 Oct;24(10):1417-1424. doi: 10.1007/s11886-022-01761-x. Epub 2022 Aug 18.
Repeat surgery for failed mitral valve prostheses and repairs are fraught with high rates of morbidity and mortality. Therefore, clinicians have evolved transcatheter technology as an alternative therapy. This review serves as an update as the field has moved out of the early learning curve of treating postsurgical mitral valve failures.
Mitral valve-in-valve procedures have higher rates of technical success and better in-hospital and 1-year mortality rates than mitral valve-in-ring cases. The higher rates of complications, including left ventricular outflow tract obstruction, paravalvular leak, valve embolization, and need for a 2nd valve, may explain these outcomes. Mitral valve-in-ring procedures have attenuated outcomes as compared to valve-in-valve. Clinicians should be cognizant of the nuanced complexities and the potential for suboptimal outcomes in using balloon-expandable valves for mitral valve-in-ring procedures.
二尖瓣假体和修复术后再次手术的发病率和死亡率都很高。因此，临床医生已经将经导管技术作为一种替代治疗方法。随着该领域走出治疗术后二尖瓣失败的早期学习曲线，本综述旨在提供最新信息。
与二尖瓣环内植入术相比，二尖瓣瓣中瓣手术的技术成功率更高，住院期间和 1 年死亡率更低。并发症发生率较高，包括左心室流出道梗阻、瓣周漏、瓣膜栓塞和需要植入第 2 个瓣膜，这可能解释了这些结果。与瓣中瓣手术相比，二尖瓣环内植入术的效果有所减弱。临床医生在使用球囊扩张瓣膜进行二尖瓣环内植入术时，应注意细微复杂情况和可能出现的不理想结果。
