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用于心脏瓣膜病的新兴经导管治疗:聚焦二尖瓣和三尖瓣手术

Emerging Transcatheter Therapies for Valvular Heart Disease: Focus on Mitral and Tricuspid Valve Procedures.

作者信息

Ktenopoulos Nikolaos, Katsaros Odysseas, Apostolos Anastasios, Drakopoulou Maria, Tsigkas Grigorios, Tsioufis Constantinos, Davlouros Periklis, Toutouzas Konstantinos, Karanasos Antonios

机构信息

First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece.

Department of Cardiology, Patras University Hospital, 26504 Patras, Greece.

出版信息

Life (Basel). 2024 Jul 2;14(7):842. doi: 10.3390/life14070842.

Abstract

The emergence of percutaneous treatment options provides novel therapeutic alternatives for older and feeble patients who are at high risk for any surgical procedure. The purpose of our review was to offer an up-to-date analysis of the rapidly expanding field of percutaneous technologies for mitral, tricuspid, and pulmonary procedures. Edge-to-edge repair is an established treatment for secondary mitral regurgitation (MR), while transcatheter mitral valve replacement is a potential and expanding option for managing both secondary and primary MR. However, additional advancements are necessary to enhance the safety and feasibility of this procedure. Transcatheter tricuspid intervention is an emerging option that was conceived after the success of transcatheter procedures in aortic and mitral valves, and it is currently still in the early stages of advancement. This can be attributed, at least in part, to the previously overlooked effect of tricuspid regurgitation on patient outcomes. The development of edge-to-edge repair represents the forefront of innovations in transcatheter procedures. There is a scarcity of data about tricuspid annuloplasty and replacement, and further study is necessary. Transcatheter mitral, tricuspid, and pulmonary procedures show prospects for the future, while their role in clinical practice has not been definitively established.

摘要

经皮治疗方案的出现为那些接受任何外科手术都具有高风险的老年体弱患者提供了新的治疗选择。我们综述的目的是对二尖瓣、三尖瓣和肺动脉手术中迅速发展的经皮技术领域进行最新分析。缘对缘修复是继发性二尖瓣反流(MR)的既定治疗方法,而经导管二尖瓣置换术是治疗继发性和原发性MR的一种有潜力且不断发展的选择。然而,需要进一步改进以提高该手术的安全性和可行性。经导管三尖瓣介入是在主动脉瓣和二尖瓣经导管手术成功后构想出来的一种新兴选择,目前仍处于早期发展阶段。这至少部分归因于之前对三尖瓣反流对患者预后影响的忽视。缘对缘修复的发展代表了经导管手术创新的前沿。关于三尖瓣环成形术和置换的数据稀缺,有必要进一步研究。经导管二尖瓣、三尖瓣和肺动脉手术展现出未来的前景,但其在临床实践中的作用尚未明确确立。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c727/11277877/1b9f96633af2/life-14-00842-g001.jpg

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