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先天性心脏病的经皮缘对缘修复:一项有前景的新技术的初步结果。

Percutaneous edge-to-edge repair in congenital heart disease: Preliminary results of a promising new technique.

作者信息

Silini Alexandre, Iriart Xavier

机构信息

University Hospital of Bordeaux, Department of Pediatric and Adult Congenital Cardiology, France.

出版信息

Int J Cardiol Congenit Heart Dis. 2022 Apr 26;8:100370. doi: 10.1016/j.ijcchd.2022.100370. eCollection 2022 Jun.

Abstract

Percutaneous edge-to-edge repair has become a valid technique for symptomatic mitral and tricuspid regurgitation in patients with acquired cardiopathies deemed ineligible for surgery. In congenital heart disease (CHD) and more specifically in systemic right ventricle atrioventricular valve regurgitation, it has a pivotal role in the disease course, functional prognosis, systemic ventricular function, and mortality. While medical therapy is not unequivocally effective, surgery (valve repair or replacement) involves discrepant long-term results that depend mainly on pre-operative systemic ventricular function; it can be too risky for patients who have undergone previous open-heart surgery and have other comorbidities. Many case reports of patients with CHD and atrioventricular regurgitation repaired percutaneously have been published. This technique seems safe and yields short-term clinical and hemodynamic improvements. The specifics of each patient's complex anatomy must be considered carefully pre-operatively, and more research is needed to assess the long-term outcomes and precise eligibility criteria.

摘要

经皮缘对缘修复已成为治疗后天性心脏病患者中症状性二尖瓣和三尖瓣反流的有效技术,这些患者被认为不适合手术治疗。在先天性心脏病(CHD)中,更具体地说,在系统性右心室房室瓣反流中,它在疾病进程、功能预后、系统性心室功能和死亡率方面起着关键作用。虽然药物治疗并非绝对有效,但手术(瓣膜修复或置换)的长期效果存在差异,主要取决于术前系统性心室功能;对于曾接受过心脏直视手术且有其他合并症的患者,手术风险可能过高。已经发表了许多经皮修复CHD和房室反流患者的病例报告。该技术似乎安全,并且能带来短期临床和血流动力学改善。术前必须仔细考虑每位患者复杂解剖结构的具体情况,还需要更多研究来评估长期疗效和精确的适应症标准。

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