Yan Chaowu
Department of Structural Heart Disease, Fuwai Hospital, 100037, Beijing, China.
Expert Rev Cardiovasc Ther. 2022 Nov;20(11):895-903. doi: 10.1080/14779072.2022.2144233. Epub 2022 Nov 10.
Personalized and stable interatrial communication is an important palliative therapy for patients with heart failure. However, this remains a technically challenging task.
In the past decades, substantial advancements in atrial septostomy for the creation of controllable and durable interatrial communication have been made, and numerous novel devices and techniques are in various stages of development. In this review, we discuss the evolving indications for atrial septostomy, current approaches with or without device implantation, and indicators for optimal interatrial communication. The combined use of radiofrequency ablation and balloon dilation (CURB) is an individualized management approach based on underlying hemodynamics, which demonstrates unique advantages in creating a sufficient interatrial communication with satisfactory stability. The advantages and disadvantages of this implant-free procedure are analyzed and its clinical prospects are assessed.
With ready availability, high safety, and efficacy, CURB is a promising procedure for creating personalized and stable interatrial communication without device implantation. Further research is required to simplify the procedure, screen optimal reference parameters for personalized therapy, and evaluate the long-term outcome in a large population of patients.
个性化且稳定的心房内交通是心力衰竭患者的一项重要姑息治疗方法。然而，这仍然是一项技术上具有挑战性的任务。
在过去几十年中，用于创建可控且持久心房内交通的房间隔造口术取得了重大进展，众多新型装置和技术正处于不同的开发阶段。在本综述中，我们讨论了房间隔造口术不断演变的适应证、有无装置植入的当前方法以及最佳心房内交通的指标。射频消融与球囊扩张联合应用（CURB）是一种基于基础血流动力学的个体化管理方法，在创建足够且稳定性良好的心房内交通方面显示出独特优势。分析了这种无植入装置手术的优缺点并评估了其临床前景。
由于具备可得性、高安全性和有效性，CURB是一种有前景的无需植入装置即可创建个性化且稳定心房内交通的手术方法。需要进一步研究以简化该手术、筛选个性化治疗的最佳参考参数，并在大量患者中评估长期结果。
