Chan Nicholas, Dong Tiffany, Sabbak Nabil, Xu Bo, Wang Tom Kai Ming
Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland, OH 44195, USA.
Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA.
Life (Basel). 2023 Jul 5;13(7):1511. doi: 10.3390/life13071511.
Mitral regurgitation (MR) is the most common form of valvular heart disease in the United States, and there are established guidelines for indications for requiring mitral valve surgeries. However, there is an unmet clinical need for a subset of high-risk MR patients, especially those with advanced age, heart failure and/or secondary MR. Following the successes of transcatheter aortic valve replacements, significant advances have occurred over the last decade in transcatheter mitral valve interventions in order to manage these patients in both clinical practice and trials. The three main types of these interventions include a transcatheter edge-to-edge repair, percutaneous mitral annuloplasty (both direct and indirect) and transcatheter mitral valve replacement (including when applied to a prior prosthetic valve, annuloplasty ring and mitral annuloplasty ring). This review aims to discuss the contemporary techniques, evidence, indications, multimodality imaging evaluations and outcomes of the various transcatheter mitral valve interventions.
二尖瓣反流(MR)是美国最常见的心脏瓣膜病形式,并且对于二尖瓣手术的指征已有既定指南。然而,对于一部分高危MR患者,尤其是高龄、心力衰竭和/或继发性MR患者,临床需求仍未得到满足。继经导管主动脉瓣置换术取得成功之后,在过去十年中,经导管二尖瓣干预取得了重大进展,以便在临床实践和试验中对这些患者进行治疗。这些干预的三种主要类型包括经导管缘对缘修复、经皮二尖瓣环成形术(直接和间接)以及经导管二尖瓣置换术(包括应用于先前的人工瓣膜、瓣环成形环和二尖瓣瓣环成形环时)。本综述旨在讨论各种经导管二尖瓣干预的当代技术、证据、指征、多模态成像评估和结果。