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Advances in transcatheter mitral and tricuspid therapies.
BMC Cardiovascular Disorders ( IF 2.1 ) Pub Date : 2020-01-07 , DOI: 10.1186/s12872-019-01312-3
Pavel Overtchouk 1, 2 , Nicolo Piazza 2 , Juan Granada 3 , Osama Soliman 4, 5 , Bernard Prendergast 6 , Thomas Modine 7, 8
Affiliation  

BACKGROUND While rheumatic mitral stenosis has been effectively treated percutaneously for more than 20 years, mitral and tricuspid regurgitation treatment appear as a contemporary unmet need. The advent of transcatheter therapies offer new treatment options to often elderly and frail patients at high risk for open surgery. We aimed at providing an updated review of fast-growing domain of transcatheter mitral and tricuspid technology. MAIN BODY We reviewed the existing literature on mitral and tricuspid transcatheter therapies. Mitraclip is becoming an established therapy for secondary mitral regurgitation in selected patients with disproportionately severe regurgitation associated with moderate left ventricle dysfunction. Evidence is less convincing for primary mitral regurgitation. Transcatheter mitral valve replacement is a promising emerging alternative to transcatheter repair, for secondary as well as primary mitral regurgitation. But further development is needed to improve delivery. Transcatheter tricuspid intervention arrives late after similar technologies have been developed for aortic and mitral valves and is currently at its infancy. This is likely due in part to previously under-recognized impact of tricuspid regurgitation on patient outcomes. Edge-to-edge repair is the most advanced transcatheter solution in development. Data on tricuspid annuloplasty and replacement is limited, and more research is warranted. CONCLUSION The future appears bright for transcatheter mitral therapies, albeit their place in clinical practice is yet to be clearly defined. Tricuspid transcatheter therapies might address the unmet need of tricuspid regurgitation treatment.

中文翻译:

经导管二尖瓣和三尖瓣治疗的进展。

背景技术尽管经皮治疗风湿性二尖瓣狭窄已有20多年的历史,但二尖瓣和三尖瓣反流治疗似乎是当代未满足的需求。经导管疗法的出现为经常面临开放手术高风险的老年和体弱患者提供了新的治疗选择。我们的目的是对快速增长的经导管二尖瓣和三尖瓣技术领域进行最新综述。主体 我们回顾了有关二尖瓣和三尖瓣经导管治疗的现有文献。Mitraclip 正在成为继发性二尖瓣反流的既定疗法,用于治疗伴有中度左心室功能障碍的严重反流患者。原发性二尖瓣反流的证据缺乏说服力。经导管二尖瓣置换术是经导管修复术的一种有前途的新兴替代方案,适用于继发性和原发性二尖瓣反流。但需要进一步开发来改善交付。经导管三尖瓣介入治疗在主动脉瓣和二尖瓣的类似技术开发出来之后才出现,目前还处于起步阶段。这可能部分是由于之前没有充分认识到三尖瓣反流对患者预后的影响。边对边修复是正在开发的最先进的经导管解决方案。关于三尖瓣环成形术和置换术的数据有限,需要进行更多研究。结论 经导管二尖瓣治疗的前景一片光明,尽管其在临床实践中的地位尚未明确。三尖瓣经导管治疗可能会解决三尖瓣反流治疗未得到满足的需求。
更新日期:2020-01-07
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