周逸蒋,夏炜聪,王凯,李军,崔亚薇,王开立,牟芸,库沙尼·热依汉,郭晓纲

• 1:浙江大学医学院附属第一医院心血管内科
• 2:浙江大学医学院附属第一医院心血管超声中心

摘要(Abstract)：

持续性心房颤动等因素可致二尖瓣、三尖瓣瓣环扩张及瓣叶对合不全，诱发房性功能性二尖瓣和三尖瓣重度反流，患者常出现明显心力衰竭症状且预后不良。对外科手术高危或禁忌的单纯二尖瓣或三尖瓣重度反流患者，经导管缘对缘修复（TEER）是重要的替代疗法，可有效减轻瓣膜反流并改善心功能；虽缺乏针对房性功能性反流的大规模数据，现有经验仍显示TEER可显著减少反流、提高患者的生活质量。然而，双瓣介入治疗存在挑战，特别是双瓣同期联合TEER修复技术更复杂、时间更长，且风险更高。国外数据表明，同期或者分期双瓣介入修复均可有效改善心功能并提高生存率，但最佳的介入策略仍待进一步研究。我国因三尖瓣TEER器械尚未上市，目前只能采取分期处理。本病例报道1例房性功能性二尖瓣、三尖瓣重度反流的患者，成功行分期TEER。1年随访，双瓣反流持续改善，表明了分期行TEER双房室瓣反流是一种可行且有效的治疗方案。

关键词(KeyWords)： 经导管缘对缘修复;二尖瓣反流;三尖瓣反流

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目（2023YFC3606500）;; 浙江省自然科学基金项目（LY21H020007）;; 江西省自然科学基金资助项目（20242BAB25431）;; 江西省重点研发计划项目（20243BBI91021）

作者(Author): 周逸蒋,夏炜聪,王凯,李军,崔亚薇,王开立,牟芸,库沙尼·热依汉,郭晓纲

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