经导管三尖瓣介入治疗的研究现状

Current status of transcatheter tricuspid valve intervention treatment

三尖瓣曾被认为是心血管领域中“被遗忘的瓣膜”,三尖瓣病变以三尖瓣关闭不全(tricuspid regurgitation,TR)为主,患者基数庞大。长期以来TR患者因外科手术死亡率较高而大多接受药物保守治疗,因此TR患者的有效治疗远未满足。随着介入技术的发展,经导管三尖瓣介入治疗(transcatheter tricuspid valve intervention,TTVI)有望成为一种更优选择。近年来,已有多款TTVI器械进入临床试验,取得了较好的效果。由于TTVI技术开展较晚,临床应用积累不够,在进行临床试验时,尚无统一的入组标准以及研究终点的评价指标。该文着重介绍不同TTVI器械,并就其治疗的现状、研究进展及面临的问题进行阐述。

In historic perspectives,tricuspid valve was considered as“forgotten valve”in the cardiovascular field.Tricuspid regurgitation(TR)is the main disease of the tricuspid valve,and the number of patients is large.TR patients have mostly treated conservatively with drugs due to high surgical mortality,so the effective treatment of TR patients is far from satisfactory.With the development of interventional technology,transcatheter tricuspid valve intervention(TTVI)is expected to become a better choice.In recent years,a number of TTVI devices have entered clinical trials and achieved good results.Due to the late development of TTVI technology and insufficient accumulation of clinical applications,there are no uniform inclusion criteria and evaluation indicators for research endpoints when conducting clinical trials.This article focuses on the introduction of different instruments of TTVI,and summarizes the current status,research progress and problems of these treatments.