Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
JACC Heart Fail. 2023 Aug;11(8 Pt 2):1084-1102. doi: 10.1016/j.jchf.2023.07.020.
There is growing evidence that severe tricuspid regurgitation (TR) impacts clinical outcomes in a variety of cardiovascular disease states. The late presentation of patients with advanced TR highlights the underappreciation of the disease, as well as the pitfalls of current guideline-directed medical management. Given the high in-hospital mortality associated with isolated tricuspid valve surgery, transcatheter options continue to be explored with the hope of improved survival and reduced heart failure hospitalizations. In this review, we explore the physiology of TR, discuss the etiologic classes of TR, and explore the transcatheter options for treatment and who might benefit from device therapy.
越来越多的证据表明,严重的三尖瓣反流(TR)会影响多种心血管疾病的临床结局。晚期出现严重 TR 的患者突出表明了对该病的认识不足,以及当前指南指导的药物治疗存在缺陷。鉴于孤立性三尖瓣手术相关的院内高死亡率,人们仍在不断探索经导管治疗方法,以期改善生存率和减少心力衰竭住院。在这篇综述中,我们探讨了 TR 的生理学,讨论了 TR 的病因分类,并探讨了治疗的经导管选择以及哪些患者可能受益于器械治疗。