SEE PAGE 25 T ranscatheter mitral valve (MV) repair and replacement (TMVR) are following rapidly on the heels of transcatheter aortic valve replacement (TAVR). However, there are some significant differences between the 2 treatments that serve to set different expectations. Whereas TAVR essentially treats 1 disease, calcific aortic stenosis, with 2 options, balloon-expandable or selfexpanding valves, the causes of mitral regurgitation (MR) are multiple and the potential solutions consequentially are much more complex and diverse. There are at least 30 medical devices in various stages of development with the goal of either repairing or replacing the MV by a transcatheter approach. MR can be divided generally into 2 categories, primary (degenerative) and secondary (functional). Primary MR is due to an abnormality of either or both mitral leaflets, usually either prolapse or flail cords, most commonly of the mid portion (P2) of the posterior leaflet. Optimal surgical treatment of primary MR is a repair involving either resection of the diseased segment with reconstruction or increasingly by replacement of the elongated or ruptured cords with artificial cords of expanded polytetrafluoroethylene (ePTFE). A partial or complete annuloplasty is also usually performed to correct the accompanying annular dilation.

中文翻译：

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人工脐带 TMVR 治疗二尖瓣关闭不全

参见第 25 页 继经导管主动脉瓣置换术 (TAVR) 之后，经导管二尖瓣 (MV) 修复和置换术 (TMVR) 迅速跟进。然而，用于设定不同期望的两种处理之间存在一些显着差异。虽然 TAVR 主要治疗 1 种疾病，钙化性主动脉瓣狭窄，有两种选择，球囊扩张式或自扩张式瓣膜，但二尖瓣关闭不全 (MR) 的原因是多方面的，因此潜在的解决方案也更加复杂和多样。至少有 30 种医疗器械处于不同的开发阶段，其目标是通过经导管方法修复或更换 MV。MR一般可分为两类，原发性（退行性）和继发性（功能性）。原发性 MR 是由于一个或两个二尖瓣瓣叶异常，通常是脱垂或连枷索，最常见的是后叶的中部（P2）。原发性 MR 的最佳手术治疗是一种修复，包括切除病变节段并进行重建，或者越来越多地通过用膨体聚四氟乙烯 (ePTFE) 人造脐带替换拉长或破裂的脐带。通常还进行部分或完全瓣环成形术以纠正伴随的瓣环扩张。