Dannenberg Varius, Demirel Caglayan, Bartunek Anna, Bartko Philipp E
Department for Internal Medicine II, Cardiology, Medical University of Vienna, Vienna, Austria.
Department of Anaesthesiology, General Intensive Care and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Medical University Vienna, Vienna, Austria.
JACC Case Rep. 2025 Jan 15;30(2):102760. doi: 10.1016/j.jaccas.2024.102760.
Mitral and tricuspid regurgitation, linked to high morbidity and mortality, are increasingly treated with interventional edge-to-edge repair, showing excellent results in favorable anatomy. Recently, interventional valve replacement strategies have emerged. We present a patient with severe dyspnea and leg edema who was diagnosed with severe mitral and torrential tricuspid regurgitation. In one procedure, she underwent mitral edge-to-edge repair with a PASCAL Ace and transcatheter tricuspid valve replacement with an EVOQUE 48 mm (both Edwards Lifesciences). Tricuspid regurgitation was reduced to trace, and mitral regurgitation was mild and stable at 1 month of follow-up. It is still being determined whether mitral and tricuspid regurgitation should be treated simultaneously or in stages. Recent data show favorable results for simultaneous treatment, but tricuspid regurgitation may improve after mitral valve repair alone. Mitral and tricuspid regurgitation can be effectively treated in challenging anatomies with new replacement devices in a single procedure, offering patients fast and safe relief from both conditions.
二尖瓣和三尖瓣反流与高发病率和死亡率相关，越来越多地采用介入性缘对缘修复进行治疗，在有利的解剖结构中显示出优异的效果。最近，介入性瓣膜置换策略已经出现。我们介绍一位患有严重呼吸困难和腿部水肿的患者，其被诊断为严重二尖瓣反流和重度三尖瓣反流。在一次手术中，她接受了使用PASCAL Ace的二尖瓣缘对缘修复以及使用48毫米EVOQUE（均为爱德华生命科学公司产品）的经导管三尖瓣置换。三尖瓣反流减轻至微量，二尖瓣反流在随访1个月时为轻度且稳定。二尖瓣和三尖瓣反流应同时治疗还是分期治疗仍有待确定。最近的数据显示同时治疗效果良好，但仅二尖瓣修复后三尖瓣反流可能会改善。二尖瓣和三尖瓣反流可以通过新型置换装置在一次手术中在具有挑战性的解剖结构中得到有效治疗，为患者提供快速且安全的缓解。
