索田源,汪宇鹏

• 1:北京大学第三医院心血管内科

摘要(Abstract)：

三尖瓣反流（TR）是一种常见的心脏瓣膜疾病。随年龄不断上升的发病率、疾病晚期的高死亡率，使得越来越多的人关注到三尖瓣与TR。对于重度TR患者，以利尿剂为核心的药物治疗效果不佳，而外科治疗又面临患者年龄偏大、手术死亡率高等问题，经导管三尖瓣介入技术（TTVI）在近年来取得了迅速发展。目前，得到应用的TR介入治疗设备可分为瓣膜修复和瓣膜置换两大类，这些设备均展现出安全性和有效性，并有初步的临床试验作为支持。本文介绍了TR治疗器械及其相关临床试验的进展。

关键词(KeyWords)： 三尖瓣反流;介入治疗;经导管三尖瓣修复;经导管三尖瓣置换

Abstract:

Keywords:

基金项目(Foundation): 科技部重点研发计划项目（2023YFC2414403）

作者(Author): 索田源,汪宇鹏

参考文献(References)：

• [1]Nath J,Foster E,Heidenreich PA.Impact of tricuspid regurgitation on long-term survival[J].J Am Coll Cardiol,2004,43(3):405-409.DOI:10.1016/j.jacc.2003.09.036.
• [2]Topilsky Y,Maltais S,Medina Inojosa J,et al.Burden of tricuspid regurgitation in patients diagnosed in the community setting[J].JACC Cardiovasc Imaging,2019,12(3):43 3-442.DOI:10.1016/j.jcmg.2018.06.014.
• [3]Putthapiban P,Amini MR,Abudayyeh I.Anatomy of the tricuspid valve and pathophysiology of tricuspid regurgitation[J].Interv Cardiol Clin,2022,11(1):1-9.DOI:10.1016/j.iccl.2021.09.003.
• [4]刘晓聪,林辛辛,张新禄,等.三尖瓣反流的介入治疗[J].中国介入心脏病学杂志,2022,30(2):142-146.DOI:10.3969/j.issn.1004-8812.2022.02.013.
• [5]Hahn RT.Tricuspid Regurgitation[J].N Engl J Med,2023,388(20):1876-1891.DOI:10.1056/NEJMra2216709.
• [6]Chang JD,Manning WJ,Ebrille E,et al.Tricuspid valve dysfunction following pacemaker or cardioverter-defibrillator implantation[J].J Am Coll Cardiol,2017,69(18):2331-2341.DOI:10.1016/j.j acc.2017.02.055.
• [7]Hahn RT,Zamorano JL.The need for a new tricuspid regurgitation grading scheme[J].Eur Heart J Cardiovasc Imaging,2017,18(12):1342-1343.DOI:10.1093/ehjci/jex139.
• [8]Otto CM,Nishimura RA,Bonow RO,et al.2020 ACC/AHA guideline for the management of patients with valvular heart disease:executive summary:a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines[J].Circulation,2021,143(5):e35-e71.DOI:10.1161/CIR.0000000000000932.
• [9]Coisne A,Lancellotti P,Habib G,et al.ACC/AHA and ESC/EACTS guidelines for the management of valvular heart diseases:JACC guideline comparison[J].J Am Coll Cardiol,2023,82(8):721-734.DOI:10.1016/j.jacc.2023.05.061.
• [10]Sorajja P,Whisenant B,Hamid N,et al.Transcatheter repair for patients with tricuspid regurgitation[J].N Engl J Med,2023,388(20):1833-1842.DOI:10.1056/NEJMoa2300525.
• [11]Wild MG,Low K,Rosch S,et al.Multicenter experience with the transcatheter leaflet repair system for symptomatic tricuspid regurgitation[J].JACC Cardiovasc Interv,2022,15(13):1352-1363.DOI:10.1016/j.jcin.2022.05.041.
• [12]Vahanian A,Beyersdorf F,Praz F,et al.2021 ESC/EACTS Guidelines for the management of valvular heart disease[J].Eur Heart J,2022,43(7):561-632.DOI:10.1093/eurheartj/ehab395.
• [13]Madhavan MV,Agarwal V,Hahn RT.Transcatheter therapy for the tricuspid valve:a focused review of edge-to-edge repair and orthotopic valve replacement[J].Curr Cardiol Rep,2024,26(6):459-474.DOI:10.1007/s 11886-024-02051-4.
• [14]Lupu L,Haberman D,Chitturi KR,et al.Overview of 2024FDA advisory panel meeting on the TriClip transcatheter tricuspid valve repair system[J].Am Heart J,2024,275:21-34.DOI:10.1016/j.ahj.2024.05.011.
• [15]Lurz P,Besler C,Schmitz T,et al.Short-term outcomes of tricuspid edge-to-edge repair in clinical practice[J].J Am Coll Cardiol,2023,82(4):281-291.DOI:10.1016/j.jacc.2023.05.008.
• [16]Smith RL,Lim DS,Gillam LD,et al.1-year outcomes of transcatheter edge-to-edge repair in anatomically complex degenerative mitral regurgitation patients[J].JACC Cardiovasc Interv,2023,16(23):2820-2832.DOI:10.1016/j.jcin.2023.10.020.
• [17]Kodali SK,Hahn RT,Davidson CJ,et al.1-Year outcomes of transcatheter tricuspid valve repair[J].J Am Coll Cardiol,2023,81(18):1766-1776.DOI:10.1016/j.jacc.2023.02.049.
• [18]Badwan O,Mirzai S,Skoza W,et al.Clinical outcomes following tricuspid transcatheter edge-to-edge repair with PASCAL:a meta-analysis[J].Int J Cardiol,2023,389:131194.DOI:10.1016/j.ij card.2023.131194.
• [19]王建安,刘先宝,蒲朝霞,等.经导管三尖瓣缘对缘修复术1例及其2年随访结果[J].中华心血管病杂志,2023,51(6):662-664.DOI:10.3760/cma.j.cn112148-20230304-00120.
• [20]谢春梅,沈梦奇,朱达,等.经导管三尖瓣缘对缘修复术的应用现状[J].中国介入心脏病学杂志,2024,32(1):45-50.DOI:10.3969/j.issn.1004-8812.2024.01.009.
• [21]Perlman GS,Dvir D.Treatment of tricuspid regurgitation with the FORMA repair system[J].Front Cardiovasc Med,2018,5:140.DOI:10.3389/fcvm.2018.00140.
• [22]Asmarats L,Perlman G,Praz F,et al.Long-term outcomes of the FORMA transcatheter tricuspid valve repair system for the treatment of severe tricuspid regurgitation:insights from the firstin-human experience[J].JACC Cardiovasc Interv,2019,12(15):1438-1447.DOI:10.1016/j.jcin.2019.04.038.
• [23]Danenberg HD,Topilsky Y,Planer D,et al.Tricuspid valve repair by chordal grasping:mistral first-in-human trial results at 6 months[J].JACC Cardiovasc Interv,2023,16(2):244-246.DOI:10.1016/j.jcin.2022.09.035.
• [24]Piayda K,Bertog S,Steffan J,et al.One-year outcomes of transcatheter tricuspid valve repair with the Mistral device[J].Euro Intervention,2023,19(4):e363-e365.DOI:10.4244/EIJ-D-22-01032.
• [25]Hahn RT,Meduri CU,Davidson CJ,et al.Early feasibility study of a transcatheter tricuspid valve annuloplasty:SCOUT trial 30-day results[J].J Am Coll Cardiol,2017,69(14):1795-1806.DOI:10.1016/j.j acc.2017.01.054.
• [26]Xu H,Li W,Lee AP,et al.30-day outcomes of transcatheter tricuspid annuloplasty with the K-Clip system:a single-center,observational study[J].JACC Adv,2023,2(9):100671.DOI:10.1016/j.jacadv.2023.100671.
• [27]Santaló-Corcoy M,Asmarats L,Li CH,et al.Catheterbased treatment of tricuspid regurgitation:state of the art[J].Ann Transl Med,2020,8(15):964.DOI:10.21037/atm.2020.03.219.
• [28]K?rber MI,Roder F,Ger?ek M,et al.Leaflet morphology and its implications for direct transcatheter annuloplasty of tricuspid regurgitation[J].JACC Cardiovasc Interv,2023,16(6):693-702.DOI:10.1016/j.jcin.2023.01.364.
• [29]Stolz L,Stocker TJ,Weckbach LT,et al.4-year follow-up after transcatheter tricuspid valve replacement using the EVOQUE system[J].JACC Case Rep,2024,29(14):102393.DOI:10.1016/j.j accas.2024.102393.
• [30]Kodali S,Hahn RT,Makkar R,et al.Transfemoral tricuspid valve replacement and one-year outcomes:the TRISCEND study[J].Eur Heart J,2023,44(46):4862-4873.DOI:10.1093/eurheartj/ehad667.
• [31]Hahn RT,George I,Kodali SK,et al.Early single-site experience with transcatheter tricuspid valve replacement[J].JACC Cardiovasc Imaging,2019,12(3):416-429.DOI:10.1016/j.jcmg.2018.08.034.
• [32]Wang Y,Liu Y,Meng X,et al.Comparing outcomes of transcatheter tricuspid valve replacement and medical therapy for symptomatic severe tricuspid regurgitation:a retrospective study[J].Eur J Med Res,2024,29(1):407.DOI:10.1186/s40001-024-01947-9
• [33]Blasco-Turrion S,Briedis K,Estevez-Loureiro R,et al.Bicaval TricValve implantation in patients with severe symptomatic tricuspid regurgitation:1-year follow-up outcomes[J].JACC Cardiovasc Interv,2024,17(1):60-72.DOI:10.1016/j.j cin.2023.10.043.
• [34]Wild MG,Lubos E,Cruz-Gonzalez I,et al.Early clinical experience with the TRICENTO bicaval valved stent for treatment of symptomatic severe tricuspid regurgitation:a multicenter registry[J].Circ Cardiovasc Interv,2022,15(3):e011302.DOI:10.1161/CIRCINTERVENTIONS.121.011302.