经导管三尖瓣环成形术中国专家共识(试行版)Chinese expert consensus on transcatheter tricuspid valve annuloplasty(pilot version)
中国医师协会心血管内科医师分会结构性心脏病学组 ,国家放射与治疗临床医学研究中心 ,苏州工业园区东方华夏心血管健康研究院 ,张晓春,潘文志,宋光远,李伟,杨雪
摘要(Abstract):
三尖瓣反流(TR)是常见的瓣膜性心脏病之一,严重的TR与患者不良预后相关。近年来,多项经导管三尖瓣介入治疗(TTVI)技术,尤其是经导管三尖瓣环成形术(TTVA)技术取得重大突破。为了促进TTVA技术在我国安全规范、健康地发展,本共识从技术背景、团队构成与临床评估、影像学评估、手术流程、并发症防治、术后用药、随访等方面详细介绍了TTVA技术,并提炼梳理了10个核心观点,有利于读者迅速掌握共识的精髓要点。
关键词(KeyWords): 三尖瓣反流;经导管三尖瓣介入治疗;经导管三尖瓣环成形术;专家共识
基金项目(Foundation):
作者(Author): 中国医师协会心血管内科医师分会结构性心脏病学组 ,国家放射与治疗临床医学研究中心 ,苏州工业园区东方华夏心血管健康研究院 ,张晓春,潘文志,宋光远,李伟,杨雪
参考文献(References):
- [1]Hahn RT,Badano LP,Bartko PE,et al.Tricuspid regurgitation:recent advances in understanding pathophysiology,severity grading and outcome[J].Eur Heart J Cardiovasc Imaging,2022,23(7):913-929.DOI:10.1093/ehjci/jeac009.
- [2] Wang N,Fulcher J,Abeysuriya N,et al.Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure:a systematic review and meta-analysis[J].Eur Heart J,2019,40(5):476-484.DOI:10.1093/eurheartj/ehy641.
- [3]索田源,汪宇鹏.三尖瓣反流介入治疗进展[J].中国介入心脏病学杂志,2024,32(10):588-595.DOI:10.3969/j.issn.1004-8812.2024.10.006.
- [4]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.
- [5]中国医师协会心血管内科医师分会结构性心脏病学组,苏州工业园区东方华夏心管健康研究院.三尖瓣反流经导管治疗的中国专家共识[J].中华心脏与心律电子杂志,2024,12(3):129-139.DOI:10.3877/cma.j.issn.2095-656 8.2024.03.001.
- [6]Singh JP,Evans JC,Levy D,et al.Prevalence and clinical determinants of mitral,tricuspid,and aortic regurgitation(the Framingham Heart Study)[J].Am J Cardiol,1999,83(6):897-902.DOI:10.1016/s0002-9149(98)01064-9.
- [7]Antunes MJ,Rodriguez Palomares J,Prendergast B,et al.Management of tricuspid valve regurgitation:position statement of the European Society of Cardiology Working Groups of Cardiovascular Surgery and Valvular Heart Disease[J].Eur J Cardiothorac Surg,2017,52(6):1022-1030.DOI:10.1093/ejcts/ezx279.
- [8]Rodés-Cabau J,Taramasso M,O'Gara PT.Diagnosis and treatment of tricuspid valve disease:current and future perspectives[J].Lancet,2016,388(10058):2431-2442.DOI:10.1016/S0140-6736(16)00740-6.
- [9] Topilsky Y,Khanna A,Le Tourneau T,et al.Clinical context and mechanism of functional tricuspid regurgitation in patients with and without pulmonary hypertension[J].Circ Cardiovasc Imaging,2012,5(3):314-323.DOI:10.1161/CIRCIMAGING.111.967919.
- [10]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):433-442.DOI:10.1016/j.j cmg.2018.06.014.
- [11]Condello F,Gitto M,Stefanini GG.Etiology,epidemiology,pathophysiology and management of tricuspid regurgitation:an overview[J].Rev Cardiovasc Med,2021,22(4):1115-1142.DOI:10.31083/j.rcm2204122.
- [12] Nishimura RA,Otto CM,Bonow RO,et al.2014 AHA/ACC Guideline for the management of patients with valvular heart disease:executive summary:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Am Coll Cardiol,2014,63(22):2438-2488.DOI:10.1016/j.jacc.2014.02.537.
- [13]Baumgartner H,Falk V,Bax JJ,et al.2017 ESC/EACTS Guidelines for the management of valvular heart disease[J].Eur Heart J,2017,38(36):2739-2791.DOI:10.1093/eurheartj/ehx391.
- [14]Kim YJ,Kwon DA,Kim HK,et al.Determinants of surgical outcome in patients with isolated tricuspid regurgitation[J].Circulation,2009,120(17):1672-1678.DOI:10.1161/CIRCULATIONAHA.109.849448.
- [15]Kuwata S,Taramasso M,Nietlispach F,et al.Transcatheter tricuspid valve repair toward a surgical standard:first-in-man report of direct annuloplasty with a cardioband device to treat severe functional tricuspid regurgitation[J].Eur Heart J,2017,38(16):1261.DOI:10.1093/eurheartj/ehw660.
- [16]Gray WA,Abramson SV,Lim S,et al.1-Year outcomes of cardioband tricuspid valve reconstruction system early feasibility study[J].JACC Cardiovasc Interv,2022,15(19):1921-1932.DOI:10.1016/j.jcin.2022.07.006.
- [17]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.jacc.2017.01.054.
- [18] Taramasso M,Alessandrini H,Latib A,et al.Outcomes after current transcatheter tricuspid valve intervention:midterm results from the international TriValve registry[J].JACC Cardiovasc Interv,2019,12(2):155-165.DOI:10.1016/j.jcin.2018.10.022.
- [19]Ghanta RK,Chen R,Narayanasamy N,et al.Suture bicuspidization of the tricuspid valve versus ring annuloplasty for repair of functional tricuspid regurgitation:midterm results of 237 consecutive patients[J].J Thorac Cardiovasc Surg,2007,133(1):117-126.DOI:10.1016/j.jtcvs.2006.08.068.
- [20]Taramasso M,Vanermen H,Maisano F,et al.The growing clinical importance of secondary tricuspid regurgitation[J].J Am Coll Cardiol,2012,59(8):703-710.DOI:10.1016/j.jacc.2011.09.069.
- [21]Zhang X,Jin Q,Li W,et al.Transcatheter annuloplasty with the K-Clip system for tricuspid regurgitation:one-year results from the TriStar study[J].EuroIntervention,2025,21(5):e262-e271.DOI:10.4244/EIJ-D-24-00591.
- [22]Xu H,Chen M,Wang Z,et al.Mid-term outcomes of K-clip transcatheter tricuspid annuloplasty system in patients with severe functional tricuspid regurgitation[J].JACC Cardiovasc Interv,2024,17(23):2796-2807.DOI:10.1016/j.jcin.2024.10.007.
- [23]Zhang X,Jin Q,Pan W,et al.First-in-human study of the K-Clip~(TM)transcatheter annular repair system for severe functional tricuspid regurgitation[J].Int J Cardiol,2023,390:131174.DOI:10.1016/j.ijcard.2023.131174.
- [24]Lin D,Jin Q,Miao J,et al.Transcatheter tricuspid annuloplasty in tricuspid regurgitation patients with right ventricular-pulmonaryarterial uncoupling[J].JACC Asia,2025,5(3 Pt 2):424-433.DOI:10.1016/j.jacasi.2025.01.004.
- [25]Lin DW,Zou LW,Miao JX,et al.Outcomes of K-clip implantation for functional tricuspid regurgitation accompanied with persistent atrial fibrillation[J].J Cardiovasc Dev Dis,2025,12(2):55.DOI:10.3390/jcdd12020055.
- [26]Zhang X,Lin D,Li Wei,et al.One-year outcomes of transcatheter tricuspid annuloplasty for patients with severe atrial functional tricuspid regurgitation[J].JACC Cardiovasc Interv,2024,17(23):2843-2844.DOI:10.1016/j.jcin.2024.09.076.
- [27]Dreyfus J,Audureau E,Bohbot Y,et al.TRI-SCORE:a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery[J].Eur Heart J,2022,43(7):654-662.DOI:10.1093/eurheartj/ehab679.
- [28]Adamo M,Russo G,Pagnesi M,et al.Prediction of mortality and heart failure hospitalization after transcatheter tricuspid valve interventions:validation of TRISCORE[J].JACC Cardiovasc Interv,2024,17(7):859-870.DOI:10.1016/j.jcin.2024.02.013.
- [29] Lee AP,Ni Y,Lam YY.Imaging for transcatheter tricuspid annuloplasty using the K-clip device[J].Circ Cardiovasc Imaging,2023,16(6):e015033.DOI:10.1161/CIRCIMAGING.122.015033.
- [30]Yang IY,Pogatchnik BP.Computed tomography planning for transcatheter tricuspid valve interventions[J].Semin Roentgenol,2024,59(1):87-102.DOI:10.1053/j.ro.2023.11.001.
- [31]Park JB,Kim HK,Jung JH,et al.Prognostic value of cardiac MR imaging for preoperative assessment of patients with severe functional tricuspid regurgitation[J].Radiology,2016,280(3):723-734.DOI:10.1148/radiol.2016151556.
扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享