经皮MitraClip介入治疗二尖瓣反流1年随访报道  

1-Year follow-up of percutaneous treatment of mitral regurgitation by MitraClip

作　　者：谭冠昶[1] 卢志南 梁逸伦 张海彤 宋光远 林逸贤 李沛威 TAN Guan-chang;LU Zhi-nan;LIANG Yi-lun;ZHANG Hai-tong;SONG Guang-yuan;LIN Yi-xian;LI Pei-wei(Department of Cardiology,Kiang Wu Hospital,999078 Macao,China)

机构地区：[1]澳门镜湖医院心内科,中国澳门999078 [2]首都医科大学附属北京安贞医院心脏瓣膜病介入中心 [3]澳门科大医院心内科 [4]中山大学附属第三医院心内科 [5]香港嘉诺撒医院亚洲心脏科中心 [6]香港中文大学医学院内科及药物治疗学系心脏科

出　　处：《中国介入心脏病学杂志》2021年第10期564-569,共6页Chinese Journal of Interventional Cardiology

摘　　要：目的旨在评估经皮MitraClip介入治疗外科手术高风险或有手术禁忌的严重二尖瓣反流(MR)患者中期的安全性和有效性。方法本研究为单中心、回顾性队列研究,纳入2016年1月1日至2019年12月31日于中国澳门镜湖医院接受经皮MitraClip介入治疗的重度MR患者。收集患者住院期间的临床基线特征和超声心动图指标,术后6个月以及1年进行随访,评估患者心功能状态、超声心动图指标变化以及严重不良并发症发生情况。结果共入选25例患者,平均年龄(74.5±6.2)岁,其中男8例(8/25);退行性MR 9例(9/25),功能性MR 16例(16/25)。25例患者术后即刻MR面积和肺动脉收缩压(PASP)较术前显著下降[分别是(4.58±2.52)cm^(2)比(11.51±5.31)cm^(2),P<0.001;(38.00±10.09)mmHg比(46.48±14.67)mmHg(1 mmHg=0.133 kPa),P=0.026];三尖瓣反流(TR)面积、左心室舒张末期内径、左心室收缩末期内径及左心室射血分数等均较术前有所改善,但差异均无统计学意义(均P>0.05)。术后6个月及1年时,MR面积、TR面积及PASP均较术前显著改善(均P<0.05)。在围术期及随访过程中无严重并发症和死亡发生。结论经皮MitraClip介入治疗对外科手术高风险或有手术禁忌的严重MR具有较好的安全性和有效性,且中期随访时MR显著改善。Objective To evaluate the safety and efficacy of percutaneous MitraClip intervention therapy in patients with severe mitral regurgitant(MR)at high surgical risk or contraindicated.Methods This study was a single-center,retrospective cohort study involving patients with severe MR who received percutaneous MitraClip interventional therapy in KINGWU Hospital,Macao,China f rom January 1,2016 to December 31,2019.Baseline clinical characteristics and echocardiographic indicators during hospitalization were collected,and changes of the cardiac function,echocardiographic indicators and serious adverse complications were evaluated at 6-month and 1-year during the follow-up.Results A total of 25 patients were enrolled with an average age of(74.5±6.2)years,including 8 males(8/25).There were 9 patients with degenerative MR(9/25)and 16 patients with functional MR(16/25).In 25 patients,the immediate post-procedure MR area and pulmonary artery systolic pressure(PASP)were significantly lower than those at baseline[(4.58±2.52)cm^(2) vs.(11.51±5.31)cm^(2),P<0.001;(38.00±10.09)mm Hg vs.(46.48±14.67)mmHg,P=0.026,respectively];Tricuspid regurgitation(TR)area,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were all improved compared with those before procedure,but the differences were not statistically significant(all P>0.05).MR area,TR area and PASP were significantly improved at 6-month and 1-year after procedure(all P<0.05).No serious complications or death occurred during the follow-up.Conclusions Percutaneous MitraClip interventional therapy showed good safety and efficacy for severe MR with high surgical risk or contraindications,and MR degree was significantly improved at mid-term follow-up.

关 键 词：二尖瓣反流 外科手术 高风险 经皮二尖瓣修复 

分 类 号：R542.5[医药卫生—心血管疾病]