应用Cardioband系统治疗功能性二尖瓣反流的研究进展

Cardioband System in Treatment of Functional Mitral Regurgitation

功能性二尖瓣反流是指瓣膜结构无器质性病变,继发于左室重塑及收缩功能障碍的二尖瓣闭合不全。其大多合并缺血性或非缺血性心肌病、心力衰竭等,往往提示预后不良。相较于退行性二尖瓣反流,功能性二尖瓣反流的外科治疗尚未被证明具有显著获益。Cardioband系统是首个达到外科手术效果的经皮二尖瓣环成形设备,它能通过介入的方式将特制的成形环准确固定于二尖瓣环处,有效缩减二尖瓣环尺寸以降低反流量。Cardioband系统在高危功能性二尖瓣反流患者的治疗中具有良好的安全性和有效性,但其适用标准及远期疗效仍需更多的临床试验进一步探索。

Functional mitral regurgitation(FMR)is the mitral insufficiency that occurs without organic mitral valve disease and secondary to left ventricular remolding and dysfunction.It is usually complicated with the ischemic/nonischemic cardiomyopathy and heart failure,which often be associated with a worse prognosis.Compared to degenerative mitral regurgitation,the benefits of surgery to FMR are uncertain.The Cardioband system is the first percutaneous mitral valve annuloplasty device to achieve surgical result.This device can accurately fix the special annuloplasty band to mitral annulus and efficiently reduce annular dimensions and regurgitant volume.It has demonstrated safety and efficiency in high-risk patients with FMR,but the applicable standard and long-term prognosis still need to be explored by more coherent clinical trial.