治疗瓣膜性心脏病的新兴经导管疗法:聚焦二尖瓣和三尖瓣手术

Life Pub Date : 2024-07-02 DOI:10.3390/life14070842
N. Ktenopoulos, O. Katsaros, A. Apostolos, M. Drakopoulou, Grigoris Tsigkas, Constantinos Tsioufis, P. Davlouros, Konstantinos Toutouzas, A. Karanasos
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引用次数: 0

摘要

经皮治疗方法的出现为年老体弱、手术风险高的患者提供了新的治疗选择。我们的综述旨在对迅速扩展的二尖瓣、三尖瓣和肺手术经皮技术领域进行最新分析。边缘对边缘修补术是治疗继发性二尖瓣反流(MR)的成熟疗法,而经导管二尖瓣置换术则是治疗继发性和原发性二尖瓣反流的潜在且不断扩展的选择。然而,要提高这种手术的安全性和可行性,还需要更多的进步。经导管三尖瓣介入治疗是在经导管主动脉瓣和二尖瓣手术取得成功后出现的一种新选择,目前仍处于早期发展阶段。这至少可以部分归因于以前被忽视的三尖瓣反流对患者预后的影响。边缘到边缘修复术的发展代表了经导管手术创新的最前沿。有关三尖瓣瓣环成形术和置换术的数据还很少,有必要进行进一步研究。经导管二尖瓣、三尖瓣和肺动脉瓣手术展现了未来的前景,但它们在临床实践中的作用尚未明确确立。
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Emerging Transcatheter Therapies for Valvular Heart Disease: Focus on Mitral and Tricuspid Valve Procedures
The emergence of percutaneous treatment options provides novel therapeutic alternatives for older and feeble patients who are at high risk for any surgical procedure. The purpose of our review was to offer an up-to-date analysis of the rapidly expanding field of percutaneous technologies for mitral, tricuspid, and pulmonary procedures. Edge-to-edge repair is an established treatment for secondary mitral regurgitation (MR), while transcatheter mitral valve replacement is a potential and expanding option for managing both secondary and primary MR. However, additional advancements are necessary to enhance the safety and feasibility of this procedure. Transcatheter tricuspid intervention is an emerging option that was conceived after the success of transcatheter procedures in aortic and mitral valves, and it is currently still in the early stages of advancement. This can be attributed, at least in part, to the previously overlooked effect of tricuspid regurgitation on patient outcomes. The development of edge-to-edge repair represents the forefront of innovations in transcatheter procedures. There is a scarcity of data about tricuspid annuloplasty and replacement, and further study is necessary. Transcatheter mitral, tricuspid, and pulmonary procedures show prospects for the future, while their role in clinical practice has not been definitively established.
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