2020年经导管瓣膜治疗主要进展

Development of transcatheter heart valve therapy in the world in 2020

2020年由于受到疫情影响,经导管心脏瓣膜治疗发展有所放缓,但仍有可圈可点之处。主要进展包括:(1)经导管主动脉瓣置换(TAVR)术后单抗对于无抗凝指征的患者或可降低出血风险带来整体获益,但部分患者存在血栓风险,故指征仍需进一步明确;(2)中国TAVR专家共识已将外科手术低危患者纳入相对适应证;(3)MitraClip最新一代G4进入临床;(4)MitraClip术中房间隔封堵或可降低心力衰竭住院率,但封堵指征有待进一步明确;(5)Half Moon对合缘增强技术有望降低缘对缘技术瓣膜狭窄的风险,成为新的二尖瓣反流微创治疗技术;(6)经导管二尖瓣置换领域Tendyne瓣膜成为首个上市的二尖瓣瓣膜;(7)TriClip、PASCAL等三尖瓣微创修复器械获得欧洲CE认证;(8)TAVR技术正在国内迅速普及,球囊扩张式瓣膜Sapien3以及新的可回收重新定位瓣膜系统Venus-Plus已经进入国内市场,多款二尖瓣治疗器械相继亮相,国内首个三尖瓣瓣膜LuX完成FIM研究。随着器械研发和临床研究的进步,心脏瓣膜介入治疗有望惠及更多患者。

In 2020,due to the impact of the novel coronavirus epidemic,the development of transcatheter heart valve therapy has been shown to slow down,but there are still many aspects worth noting.The indication of monoclonal antibody after transcatheter aortic valve replacement(TAVR)should be further clarified.Low surgical risk patients were included in TAVR relative indications.Mitraclip G4 was approved by CE.The indication of atrial septal occlusion after mitraclip should be further clarified.The technique of coaptation augmentation is expected to become a new method of mitral valve interventional repair.Tendyne transcatheter mitral valve was approved by European Union.Transcatheter tricuspid valve treatment equipments,TriClip and PASCAL obtained CE mark.TAVR technology is being popularized rapidly in China,and what’s more,balloon dilated valve Sapien 3 and new recyclable repositioning valve system-Venus plus have entered the domestic market.A number of mitral valve therapeutic instruments have appeared one after another,and China's first tricuspid valve lux has completed its FIM research.Finally,with the improvement of devices and technology in the future,interventional therapy of heart valve is expected to benefit more patients.