经导管二尖瓣缘对缘修复术在二尖瓣反流中的应用进展  

Progress in the application of transcatheter mitral valve edge-to-edge repair in mitral regurgitation

作　　者：陈涛 于波[1] CHEN Tao;YU Bo(Department of Cardiology,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,P.R.China)

机构地区：[1]哈尔滨医科大学附属第二医院心内科,哈尔滨150086

出　　处：《华西医学》2023年第9期1281-1287,共7页West China Medical Journal

摘　　要：在过去的20年里,经导管二尖瓣缘对缘修复术(transcatheter mitral valve edge-to-edge repair,TEER)已经成为外科手术高风险的重度二尖瓣反流(mitral regurgitation,MR)患者的重要治疗选择。初期,具有里程碑意义的几项临床研究奠定了TEER治疗原发性和继发性MR的基础,但其仅涉及临床情况稳定且二尖瓣解剖结构合适的患者。随着介入治疗经验的增长、设备的迭代和术中影像技术的进步,TEER的使用范围不断扩大,其适应证不断拓宽至更复杂的二尖瓣病变和临床情况。故在临床实践中,根据患者的个体解剖学特性选择合适的器械,可以最大程度地减轻MR和减少并发症,从而优化即刻和远期预后。该文主要对MR的发病及相关机制、TEER主要器械及其临床证据、TEER的局限性及未来的发展方向进行介绍。Over the past 20 years,transcatheter mitral valve edge-to-edge repair(TEER)has become an important treatment option for patients with severe mitral regurgitation(MR)who are at high surgical risk.Initially,several landmark clinical studies established the basis of TEER for primary and secondary MR,but they only involved clinically stable patients with appropriate mitral valve anatomy.With the increasing experience of interventional therapy,the iteration of equipment and the improvement of intraoperative imaging technology,the scope of use of TEER has been continuously expanded,and its indications have been continuously expanded to more complex mitral valve lesions and clinical situations.Therefore,in clinical practice,selecting the appropriate device according to the individual anatomical characteristics of the patient can minimize MR and complications,thereby optimizing immediate and long-term prognosis.This article mainly introduces the pathogenesis and related mechanisms of MR,the main TEER devices and their clinical evidence,the limitations of TEER,and the future development direction.

关 键 词：二尖瓣反流 经导管二尖瓣缘对缘修复术 经皮二尖瓣修复术 

分 类 号：R654.2[医药卫生—外科学]