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Mitral and Tricuspid Transcatheter Interventions Current Indications and Future Directions

机译:二尖瓣和三尖瓣经导管干预措施当前指示和未来方向

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Introduction Valvular heart disease (VHD) is a common condition that has long been underappreciated although it has enormous impact on mortality and morbidity. Population-based analyses have shown a prevalence of moderate to severe mitral and tricuspid valve disease of 9.3% and 4.0% in the ageing population, respectively. [1, 2] The incremental annual costs for VHD in the US are substantial (estimated at $23.4 billion [3]) and expected to further increase given population growing and aging. In the past, a high proportion of patients with severe mitral or tricuspid valve disease has been denied treatment beyond medical therapy, mainly because of age and decreased left ventricular function that are both associated with high surgical risk.[4] Over the last years, the interventional landscape has widely expanded with new transcatheter methods emerging for both mitral and tricuspid valve treatment. In contrast to transcatheter aortic valve implantation (TAVI), the interventional treatment of mitral and tricuspid valve disease requires a substantially more versatile approach due to the different etiologies of valvular dysfunction. This paper aims to review the evolution of the field, to discuss current indications and limitations and attempts to provide a glimpse to the future of transcatheter interventions for mitral and tricuspid valve disease.
机译:引言瓣膜心脏病(VHD)是一种常见的条件,虽然它对死亡率和发病率造成了巨大的影响,但它长期被珍视。人口的分析显示出中度至严重二尖瓣和三尖瓣病的患病率分别为衰老人群中的9.3%和4.0%。 [1,2]美国VHD的增量年度成本实质性(估计为234亿美元[3]),预计会进一步增加人口生长和老化。在过去,高比例的严重二尖瓣或三尖瓣病的患者被剥夺了医学治疗的治疗,主要是因为年龄和左心室功能减少,既与高手术风险有关。[4]在过去的几年中,介入景观随着二尖瓣和三尖瓣处理的新型经沟管方法广泛扩大。与经变形管主动脉瓣植入(Tavi)相反,由于瓣膜功能障碍的不同病因,二尖瓣和三尖瓣病的介入治疗需要大致更通用的方法。本文旨在审查该领域的演变,讨论当前的指示和局限性,并试图为二尖瓣和三尖瓣病的经视截面干预措施提供一瞥。

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