Sisinni Antonio, Barreiro-Pérez Manuel, Calvo-Iglesias Francisco, Estévez-Loureiro Rodrigo
Department of Cardiology, University Hospital Alvaro Cunqueiro, 36312 Vigo, Spain.
Cardiovascular Research Group, Department of Cardiology, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute (IIS Galicia Sur), Servizo Galego de Saude, University of Vigo, 36312 Vigo, Spain.
Rev Cardiovasc Med. 2024 Apr 3;25(4):134. doi: 10.31083/j.rcm2504134. eCollection 2024 Apr.
The intricate interplay between mitral regurgitation (MR) and left ventricular outflow tract (LVOT) obstruction may result in two clinical scenarios: prosthesis-related LVOT obstruction after mitral valve replacement (TMVR) and systolic anterior motion (SAM)-associated MR. This review provides a comprehensive overview of the pathophysiology, risk assessment, and transcatheter interventions for mitigating the likelihood of LVOT obstruction in patients undergoing TMVR. In addition, it extends its focus to SAM-associated MR, elucidating the different aetiological mechanisms contributing to this phenomenon, beyond hypertrophic cardiomyopathy. Transcatheter treatment options, are explored as potential therapeutic strategies, offering insights into their hemodynamic effectiveness and limitations.
二尖瓣反流（MR）与左心室流出道（LVOT）梗阻之间复杂的相互作用可能导致两种临床情况：二尖瓣置换术（TMVR）后与人工瓣膜相关的LVOT梗阻和与收缩期前向运动（SAM）相关的MR。本综述全面概述了TMVR患者减轻LVOT梗阻可能性的病理生理学、风险评估和经导管干预措施。此外，它还将重点扩展到与SAM相关的MR，阐明了除肥厚型心肌病之外导致这种现象的不同病因机制。探讨了经导管治疗方案作为潜在的治疗策略，深入了解其血流动力学有效性和局限性。
