经导管二尖瓣反流边缘对边缘修复术：缩小差距以扩大覆盖范围。
Transcatheter Edge-to-Edge Repair of Mitral Valve Regurgitation: Closing the Gap to Broaden the Coverage.
作者信息
Imran Hafiz, Ahmad Khansa, Baig Muhammad, Elgendy Islam Y, Iqbal Nasir, Ehsan Afshin, Sharaf Barry, Gordon Paul, Saad Marwan
机构信息
Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI 02903, USA.
Lifespan Cardiovascular Institute, Providence, RI 02903, USA.
出版信息
Rev Cardiovasc Med. 2023 Jan 6;24(1):15. doi: 10.31083/j.rcm2401015. eCollection 2023 Jan.
BACKGROUND
Transcatheter edge-to-edge repair of mitral valve (M-TEER) is reasonable consideration in symptomatic patients with severe degenerative mitral regurgitation (MR) who are at high or prohibitive risk of surgical repair or replacement. In symptomatic patients on maximally tolerated medical therapy with severe secondary MR from left ventricular systolic dysfunction, M-TEER is reasonable therapeutic option.
METHODS
In this review, we present a comprehensive overview of the most recent literature and considerations for M-TEER in patients excluded from key trials. These include patients with cardiogenic shock, acute ischemic MR, atrial functional MR, failed surgical mitral valve prosthesis and pulmonary hypertension.
CONCLUSIONS
M-TEER is feasible and a reasonable alternative option for these patient populations with a significant clinical benefit. However, randomized clinical trials are needed to ascertain findings from these observational studies.
背景
对于有症状的严重退行性二尖瓣反流（MR）患者，若手术修复或置换的风险高或无法进行，经导管二尖瓣缘对缘修复术（M-TEER）是合理的考虑方案。对于因左心室收缩功能障碍而接受最大耐受药物治疗且有严重继发性MR的有症状患者，M-TEER是合理的治疗选择。
方法
在本综述中，我们全面概述了关于M-TEER的最新文献以及对被关键试验排除的患者进行M-TEER的相关考量。这些患者包括心源性休克患者、急性缺血性MR患者、心房功能性MR患者、二尖瓣人工瓣膜置换失败患者和肺动脉高压患者。
结论
M-TEER对这些患者群体是可行的，也是合理的替代选择，具有显著的临床益处。然而，需要进行随机临床试验来确定这些观察性研究的结果。
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