经导管二尖瓣置换术的研究现状

Current status of transcatheter mitral valve replacement

二尖瓣反流是最常见的心脏瓣膜病,其预后不良,给社会经济带来了沉重的负担。经导管修复用于二尖瓣反流的治疗已经较为成熟,但其解剖筛选较为严格,且对反流的改善也时常有限。随着技术的革新和器械的进步,经导管置换成为继修复之后一种新兴的二尖瓣反流治疗方式。目前数种置换器械已经进入临床试验阶段,大部分处于可行性的验证阶段。早期数据初步显示经导管置换用于二尖瓣反流的治疗是安全和有效的,仍需要更大样本的人群和更长时间的随访验证。此外,一些技术挑战仍待解决,以让更多的患者从这一创新性技术中获益。

Mitral regurgitation is the most prevalent valvular heart disease,with a poor prognosis that brings a heavy burden to population health and socio-economics.Transcatheter repair is a relatively mature technique for mitral regurgitation,but is strict in anatomical screening and the reduction of regurgitation is limited.With the advance in techniques and technology,transcatheter replacement has become an attractive treatment modality for mitral regurgitation in succession to transcatheter repair.At present,several replacement devices have initiated clinical trials to establish feasibility.Early data has shown that transcatheter replacement for mitral regurgitation is safe and effective,which needs to be confirmed with larger population and longer follow-up.Besides,some technical challenges remain to be addressed,in order to increase accessibility of this innovative technology.