经导管二尖瓣反流介入治疗现状及展望.PDF

《中国医学前沿杂志 （电子版）》2017 年第 9 卷第 7 期 ● ●  127  综述  DOI ：10.12037/YXQY.2017.07-08 经导管二尖瓣反流介入治疗现状及展望 潘文志，周达新，葛均波 （复旦大学附属中山医院　心内科，上海　200032 ） 【摘要】二尖瓣反流是常见、重要的心脏疾病，目前正迎来经导管介入治疗时代。MitraClip 具有很 高的安全性、较好的临床疗效以及较多的临床证据，目前已在全世界范围内得到广泛的临床应用， 但其临床证据仍有待进一步增强，适应证有待进一步拓宽。其他二尖瓣修复技术，如 Cardioband、 NeoChord、Mitralign 得到初步临床研究支持，也是颇有发展前景的技术，但仍需严格的大型临床试验 证实。经导管二尖瓣置入术是新近出现的具有良好发展前景的技术，有效率更高、复发率更低，其在 治疗功能性和缺血性二尖瓣反流方面可能更具优势。然而，相对于经导管瓣膜修复，经导管二尖瓣置 入术虽然有效率较高，但其安全性仍值得关注，距广泛用于临床仍有较长时间。 【关键词】二尖瓣反流 ；经导管治疗 ；介入治疗 ；经导管二尖瓣置入术 Current status and future perspectives of transcatheter treatment of mitral regurgitation PAN Wen-zhi, ZHOU Da-xin, GE Jun-bo (Department of Cardiology, Zhongshan Hosipital, Fudan University, Shanghai 200032, China) Corresponding author: ZHOU Da-xin, E-mail: zhou.daxin@ Abstract 【 】Mitral regurgitation is a common and important heart disease. Mitral regurgitation has access into the era of transcatheter intervention. MitraClip has high safety and high efficacy as well as gained many clinical evidences. MitraClip has been widely used in the world. However, the clinical evidences need to be further enhanced, and the indications need to be further broadened. Other transcatheter mitral valve repair techniques, such as Cardioband, NeoChord and Mitralign, have been supported by preliminary clinical studies and are also promising technologies, but large clinical trials are still needed to prove their safety and efficacy. Transcatheter mitral valve implantation is a novel promising technique with higher efficacy and lower recurrent rate, which may be more suitable for treating functional and ischemic mitral regurgitation. However, as compared with transcatheter valve repair, the safety of this technique causes a great deal of concern