二尖瓣返流经导管治疗策略及干预的最新综述。

IF 2.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology in Review Pub Date : 2025-02-27 DOI:10.1097/CRD.0000000000000876
Siddhant Passey, Haris Patail, Daniel Spevack, Hasan Ahmad, Suguru Ohira, Junichi Shimamura, William H Frishman, Wilbert S Aronow, Syed Abbas Haidry
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引用次数: 0

摘要

二尖瓣反流(MR)是一种常见的心脏瓣膜病,发病率很高,特别是在老年人群中。MR的管理策略已经从传统的心内直视手术发展到创新的经导管入路,解决了高危患者手术修复的局限性。经导管边缘到边缘修复,如MitraClip和PASCAL等设备,在某些患者中显示出降低MR严重程度、改善功能能力和减少心力衰竭住院治疗的疗效。环成形术和脊索修复技术的进步提供了微创选择,早期预后良好。经导管二尖瓣置换术是磁共振治疗的前沿,解决了不适合修复的解剖复杂性,尽管左心室流出道梗阻等并发症仍然存在。来自临床试验的新数据强调了患者选择和多学科心脏团队方法的重要性。在这篇综述中,讨论了每种治疗方式的适应症、手术技术、结果和相关挑战。它强调了经导管二尖瓣介入治疗的变革潜力,同时强调了持续创新和研究的必要性,以优化结果并扩大严重MR患者的治疗选择。
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Updated Review of Transcatheter Strategies and Intervention for Mitral Regurgitation.

Mitral regurgitation (MR) is a prevalent valvular heart disease with significant morbidity, particularly in aging populations. Management strategies for MR have evolved from traditional open-heart surgery to innovative transcatheter approaches, addressing the limitations of surgical repair in high-risk patients. Transcatheter edge-to-edge repair, exemplified by devices such as MitraClip and PASCAL, has shown efficacy in reducing MR severity, improving functional capacity, and decreasing heart failure hospitalizations in selected patients. Advances in annuloplasty and chordal repair offer minimally invasive options with promising early outcomes. Transcatheter mitral valve replacement represents the frontier of MR treatment, addressing anatomical complexities unsuitable for repair, though complications such as left ventricular outflow tract obstruction persist. Emerging data from clinical trials underscore the importance of patient selection and a multidisciplinary heart team approach. In this review, each modality is discussed concerning its indications, procedural techniques, outcomes, and associated challenges. It highlights the transformative potential of transcatheter mitral valve interventions while emphasizing the need for ongoing innovation and research to optimize outcomes and expand therapeutic options for patients with severe MR.

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来源期刊
Cardiology in Review
Cardiology in Review CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
0.00%
发文量
76
审稿时长
>12 weeks
期刊介绍: The mission of Cardiology in Review is to publish reviews on topics of current interest in cardiology that will foster increased understanding of the pathogenesis, diagnosis, clinical course, prevention, and treatment of cardiovascular disorders. Articles of the highest quality are written by authorities in the field and published promptly in a readable format with visual appeal
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