Rahgozar Kusha, Bruoha Sharon, Ho Edwin, Goldberg Ythan, Chau Mei, Latib Azeem
Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine New York, NY.
Department of Cardiothoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine New York, NY.
US Cardiol. 2021 Nov 2;15:e22. doi: 10.15420/usc.2021.06. eCollection 2021.
Tricuspid valve regurgitation is both globally prevalent and undertreated. Historically, surgical intervention for isolated tricuspid regurgitation (TR) was avoided despite the prevalence of TR, largely due to poor surgical outcomes and an incomplete understanding of how it independently affects mortality. Over the past two decades, TR has been shown by several studies to be an independent predictor of worse functional status and poor survival on long-term follow-up. During this same time period, transcatheter interventions for the treatment of valvular heart disease have evolved dramatically. While the transcatheter repair and replacement of the tricuspid valve in patients with severe TR remains in the early stages of investigation relative to the mitral or aortic valve, the field is rapidly expanding. Here, the authors review the field of transcatheter tricuspid valve interventions for severe TR, focusing on the orthotropic devices and valves currently available worldwide.
三尖瓣反流在全球范围内普遍存在且治疗不足。从历史上看,尽管三尖瓣反流很常见,但孤立性三尖瓣反流(TR)的外科手术干预一直被避免,这主要是由于手术效果不佳以及对其如何独立影响死亡率的认识不全面。在过去二十年中,多项研究表明,TR是长期随访中功能状态较差和生存率较低的独立预测因素。在同一时期,用于治疗心脏瓣膜疾病的经导管干预技术有了显著发展。虽然相对于二尖瓣或主动脉瓣,严重TR患者的经导管三尖瓣修复和置换仍处于研究早期阶段,但该领域正在迅速扩展。在此,作者回顾了用于严重TR的经导管三尖瓣干预领域,重点关注目前全球可用的原位装置和瓣膜。