Ningyan Wong, Keong Yeo Khung
Department of Cardiology, National Heart Centre Singapore, Singapore.
Int J Heart Fail. 2022 Jan 13;4(2):55-74. doi: 10.36628/ijhf.2021.0041. eCollection 2022 Apr.
The presence and severity of functional mitral regurgitation (FMR) is associated with worse outcomes in patients with heart failure and reduced ejection fraction. Prior to the availability of percutaneous mitral valve repair, management for FMR has been limited to medical therapy, cardiac resynchronization therapy for a specific subset of patients and surgery which has yet to demonstrate mortality benefits. Transcatheter edge-to-edge repair (TEER) of the mitral valve has emerged in the past decade as an invaluable member of the armamentarium against FMR with the 2 landmark randomized controlled trials providing deep insights on patient selection. In addition, TEER has spurred the rapid advancement in our understanding of FMR. This article seeks to provide an overview as well as our current understanding on the role of TEER in FMR.
功能性二尖瓣反流(FMR)的存在及其严重程度与射血分数降低的心力衰竭患者预后较差相关。在经皮二尖瓣修复术出现之前,FMR的治疗仅限于药物治疗、针对特定患者亚组的心脏再同步治疗以及尚未显示出死亡率获益的手术治疗。二尖瓣经导管缘对缘修复术(TEER)在过去十年中已成为治疗FMR的重要手段,两项具有里程碑意义的随机对照试验为患者选择提供了深刻见解。此外,TEER推动了我们对FMR认识的快速进步。本文旨在概述TEER在FMR中的作用以及我们目前的理解。