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经导管时代的多瓣膜性心脏病:最新综述

Multiple Valvular Heart Disease in the Transcatheter Era: A State-of-the-Art Review.

作者信息

Basman Craig, Landers David, Dudiy Yuriy, Yoon Sung-Han, Batsides George, Faraz Haroon, Anderson Mark, Kaple Ryan

机构信息

Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA.

出版信息

Struct Heart. 2024 May 3;8(4):100301. doi: 10.1016/j.shj.2024.100301. eCollection 2024 Jul.

Abstract

Although existing guidelines offer strong recommendations for single valvular dysfunction, the growing prevalence of multiple valvular heart disease (MVHD) in our aging population is challenging the clarity of clinical guidance. Traditional diagnostic modalities, such as echocardiography, face inherent constraints in precisely quantifying valvular dysfunction due to the hemodynamic interactions that occur with multiple valve involvement. Therefore, many patients with MVHD present at a later stage in their disease course and with an elevated surgical risk. The expansion of transcatheter therapy for the treatment of valvular heart disease has added new opportunities for higher-risk patients. However, the impact of isolated valve therapies on patients with MVHD is still not well understood. This review focuses on the etiology, diagnostic challenges, and therapeutic considerations for some of the most common concomitant valvular abnormalities that occur in our daily clinic population.

摘要

尽管现有指南对单一瓣膜功能障碍给出了强有力的建议,但在我们老龄化人口中,多瓣膜心脏病(MVHD)患病率的不断上升正对临床指导的清晰度构成挑战。传统的诊断方式,如超声心动图,由于多瓣膜受累时发生的血流动力学相互作用,在精确量化瓣膜功能障碍方面存在固有局限性。因此,许多MVHD患者在疾病进程较晚阶段才就诊,且手术风险较高。经导管治疗在瓣膜性心脏病治疗中的扩展为高危患者带来了新的机会。然而,单纯瓣膜治疗对MVHD患者的影响仍未得到充分了解。本综述聚焦于我们日常门诊人群中一些最常见的合并瓣膜异常的病因、诊断挑战及治疗考量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c884/11294895/287c9fb8f762/gr1.jpg

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