经导管二尖瓣置换术的并发症

Complications after transcatheter mitral valve replacement

二尖瓣反流是最常见的心脏瓣膜病,具有很高的致残率和致死率。经导管二尖瓣置换术(transcatheter mitral valve replacement,TMVR)用于外科手术不耐受以及解剖结构不适合行介入修复的原位瓣膜患者。对于外科生物瓣衰败或修复失败的患者也可行TMVR。二尖瓣复杂的解剖结构使经导管二尖瓣瓣膜的研发设计极具挑战,也增加了TMVR的难度,其并发症的风险不容忽视。TMVR并发症包括围手术期并发症及术后远期并发症。该文旨在探讨TMVR常见的并发症及对策,以期改善TMVR患者预后。

Mitral regurgitation is the most common cardiac valve disease,with high rates of morbidity and mortality.Transcatheter mitral valve replacement(TMVR)is used as a promising intervention in non-surgical patients and in those with unsuitable anatomy for transcatheter edge-to-edge repair.TMVR can also be performed for inoperable or high-risk patients with degenerated or failed bioporstheses or failed repairs,or in patients with severe annular calcifications.The complex anatomy of the mitral valves makes the design of transcatheter mitral valve prostheses extremely challenging,and increases the difficulty of TMVR procedure,thus could led to non-negligible complications including periprocedural and post-procedural long-term complications.This review aims to discuss the potential TMVRcomplications and measures implemented to mitigate these complications,in order to improve the prognosis of TMVR patients.