潘翠珍,潘文志,周达新,刘先宝,宋光远

• 1:中国医师协会超声分会超声心动图专业委员会
• 2:中国医师协会心血管内科医师分会结构性心脏病学组
• 3:复旦大学附属中山医院
• 4:浙江大学医学院附属第二医院

摘要(Abstract)：

<正>二尖瓣反流/关闭不全（mitral regurgitati on,MR）是最常见的心脏瓣膜疾病之一~([1])。超声心动图是目前诊断和评价MR最重要的影像学方法。经导管缘对缘修复（transcatheter edge-to-edge repair,TEER）为目前最成熟、指南唯一推荐的MR介入技术。与其他心脏介入手术不同，超声心动图在TEER术中具有无可替代的导航及监测作用。随着TEER代表性器械MitraClip在全世界的发展和在我国上市推广~([2-5])，以及我国研发的国产TEER器械陆续进入临床试验~([6-10])，我国临床对TEER超声心动图的指导性文件及规范化培训的需求急剧增加。虽然国际上已经发布了有关MR超声心动图评价的指导性文献~([11-13])，我国也于2019年初发布了《二尖瓣反流介入治疗的超声心动图评价中国专家共识》（简称《共识2019》)~([14])，但该共识有些内容侧重于术前评估，对术中导航监测阐述不详，且部分内容需要更新。为推进我国二尖瓣TEER（简称M-TEER，

关键词(KeyWords)： 二尖瓣反流;二尖瓣关闭不全;经导管缘对缘修复;超声心动图

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划“主动健康和老龄化科技应对专项”（2020YFC2008100）

作者(Author): 潘翠珍,潘文志,周达新,刘先宝,宋光远

参考文献(References)：

• [1] Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases:a population-based study[J]. Lancet, 2006,368(9540):1005-1011.
• [2] Mack M, Carroll JD, Thourani V, et al. Transcatheter mitral valve therapy in the united states:a report from the STS-ACC TVT Registry[J]. J Am Coll Cardiol,2021,78(23):2326-2353.
• [3] Stone GW, Lindenfeld J, Abraham WT, et al. Transcatheter mitral-valve repair in patients with heart failure[J]. N Engl J Med,2018,379(24):2307-2318.
• [4]高漫辰，段福建，张戈军，等.经导管缘对缘修复技术初步实践：MitraClip治疗二尖瓣反流多中心早期结果[J].中国胸心血管外科临床杂志，2022,29(5):547-552.
• [5]谭冠昶，卢志南，梁逸伦，等.经皮MitraClip介入治疗二尖瓣反流1年随访报道[J].中国介入心脏病学杂志，2021,29(10):564-569.
• [6] Pan W,Zhou D,Wu Y,et al. First-in human results of a novel userfriendly transcatheter edge-to-edge mitral valve repair device[J].JACC Cardiovasc Interv,2019,12(23):2441-2443.
• [7] Ge Z,Pan W,Zhou D,et al. Effect of a novel transcatheter edge-to-edge repair device on the three-dimensional geometry of mitral valve in degenerative mitral regurgitation[J]. Catheter Cardiovasc Interv,2021,97(1):177-185.
• [8] Liu X, Pu Z, Lim DS, et al. Transcatheter mitral valve repair in a high-surgical risk patient with severe degenerative mitral regurgitation using the novel DragonFly?Transcatheter Repair device-First in man implantation in China[J]. Catheter Cardiovasc Interv,2022,99(2):518-521.
• [9] Liu X, Chen Y, Lim DS, et al. Transcatheter mitral valve repair in patient with atrial functional mitral regurgitation using novel DragonFly?device[J]. Catheter Cardiovasc Interv,2022,99(5):1691-1695.
• [10]朱达，潘家华，骆志玲，等.新一代国产经导管二尖瓣缘对缘修复系统治疗重度二尖瓣反流两例[J].中国胸心血管外科临床杂志，2022,29(8):1083-1086.
• [11] Zoghbi WA, Adams D, Bonow RO,et al. Recommendations for noninvasive evaluation of native valvular regurgitation:a report from the american society of echocardiography developed in collaboration with the society for cardiovascular magnetic resonance[J]. J Am Soc Echocardiogr, 2017, 30(4):303-371.
• [12] Stone GW, Vahanian AS, Adams DH, et al. Mitral valve academic research consortium(mvarc). clinical trial design principles and endpoint definitions for transcatheter mitral valve repairand replacement:part 1:clinical trial design principles:a consensus document from the mitral valve academic research consortium[J]. J Am Coll Cardiol,2015, 66(3):278-307.
• [13] O’Gara PT, Grayburn PA, Badhwar V,et al. 2017 ACC expert consensus decision pathway on the management of mitral regurgitation:a report of the american college of cardiology task force on expert consensus decisionpathways[J]. J Am Coll Cardiol,2017, 70(19):2421-2449.
• [14]中国医师协会超声分会超声心动图专业委员会，中华医学会超声医学分会超声心动图学组，中华医学会心血管病分会结构性心脏病学组，等.二尖瓣反流介入治疗的超声心动图评价中国专家共识[J].中国介入心脏病学杂志，2019,27(1):6-12.
• [15]潘翠珍，潘文志，李伟，等.二尖瓣解剖结构及反流的超声心动图的新评价[J].中华超声影像学杂志，2020,29(12):83-87.
• [16] El Sabbagh A, Reddy YNV, Nishimura RA.Mitral valve regurgitation in the contemporary era:insights into diagnosis,management, and future directions[J]. JACC Cardiovasc Imaging,2018,11(4):628-643.
• [17] Shah PM. Current concepts in mitral valve prolapse-diagnosis and management[J]. J Cardiol,2010,56(2):125-133.
• [18] Shibata T,Takahashi Y,Fujii H, et al. Surgical considerations for atrial functional regurgitation of the mitral and tricuspid valves based on the etiological mechanism[J]. Gen Thorac Cardiovasc Surg,2021, 69(7):1041-1049.
• [19] Gaasch WH, Aurigemma GP, Meyer TE. An appraisal of the association of clinical outcomes with the severity of regurgitant volume relative to end-diastolic volume in patients with secondary mitral regurgitation[J]. JAMA Cardiol,2020,5(4):476-481.
• [20] Packer M, Grayburn PA. New evidence supporting a novel conceptual framework for distinguishing proportionate and disproportionate functional mitral regurgitation[J]. JAMA Cardiol,2020,5(4):469-475.
• [21] Lim DS, Herrmann HC, Grayburn P,et al. Consensus document on non-suitability for transcatheter mitral valve repair by edge-toedge therapy[J]. Structural Heart, 2021,5(3):227-233.
• [22] Faletra F, Grimaldi A, Pasotti E, et al. Real-time 3-dimensional transesophageal echocardiography during double percutaneous mitral edge-to-edge procedure[J]. JACC Cardiovasc Imaging,2009,2(8):1031-1033.
• [23] Halaby R, Herrmann HC, Gertz ZM,et al. Effect of mitral valve gradient after mitraclip on outcomes in secondary mitral regurgitation[J]. JACC Cardiovasc Interv,2021,14(8):879-889.
• [24] Wunderlich NC,Siegel RJ. Peri-interventional echo assessment for the MitraClip procedure[J]. Eur Heart J Cardiovasc Imaging,2013,14(10), 935-949.
• [25] Wallenborn J, Herrmann S, Hansen M,et al. Systematic echocardiographic evaluation of mitral valve regurgitation for transcatheter edge-to-edge repair[J]. Echocardiography,2016,33(7):1069-1079.
• [26]潘翠珍，周达新，潘文志，等.经心尖二尖瓣夹合术中经食管二维、三维超声心动图监测及评价规范[J].中华超声影像学杂志，2020,29(4):277-282.