Mueller Christoph S, Hagl Christian, Hausleiter Jörg, Stocker Thomas J
Herzchirurgische Klinik und Poliklinik, LMU Klinikum, LMU München, Marchioninistraße 15, 81377, Munich, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Munich, Heart Alliance, Munich, Germany.
Herz. 2025 Aug 28. doi: 10.1007/s00059-025-05328-8.
Treatment options for mitral regurgitation (MR) have markedly evolved over the past few decades, with mitral valve transcatheter edge-to-edge repair (M-TEER) expanding the clinical armamentarium of guideline-directed medical therapy and surgical techniques. However, the variety of mitral valve anatomies, the presence of heart failure (HF), and consideration of the individual patient risk require a multidisciplinary Heart Team approach to identify the optimal treatment for MR for each patient. Despite the growing field of transcatheter mitral interventions and the longstanding availability of surgical mitral valve repair and replacement, evidence from randomized clinical trials comparing intervention with surgery remains scarce. In the meantime, the increasing safety and experience of surgical and interventional procedures have shifted the perspective on mitral valve disease in terms of when and how to treat it. Therefore, the multidisciplinary Heart Team discussion has become of paramount importance in the evaluation and treatment decisions for patients with mitral valve disease.
在过去几十年中，二尖瓣反流（MR）的治疗选择有了显著进展，二尖瓣经导管缘对缘修复术（M-TEER）扩展了指南指导的药物治疗和外科技术的临床手段。然而，二尖瓣解剖结构的多样性、心力衰竭（HF）的存在以及对个体患者风险的考量，需要多学科心脏团队的方法来为每位患者确定MR的最佳治疗方案。尽管经导管二尖瓣介入治疗领域不断发展，且外科二尖瓣修复和置换术长期可用，但比较介入治疗与手术治疗的随机临床试验证据仍然匮乏。与此同时，外科手术和介入手术安全性的提高以及经验的积累，在何时以及如何治疗二尖瓣疾病方面改变了对二尖瓣疾病的看法。因此，多学科心脏团队讨论在二尖瓣疾病患者的评估和治疗决策中变得至关重要。
