Percutaneous valve procedures: what is the future?
Percutaneous valve procedures: what is the future?
复制标题
经皮瓣膜手术：未来是什么？
DOI：
10.1097/01.hco.0000153455.98706.63
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发表时间：
2005
影响因子：
2.3
通讯作者：
C. Acar
中科院分区：
文献类型：
--
作者：
A. Vahanian;C. Acar
自安德烈亚斯·格伦齐格27年前提出介入心脏病学以来，介入心脏病学的范围已经从冠状动脉疾病扩展到外周疾病、先天性疾病和瓣膜疾病。自20世纪80年代中期以来，经皮二尖瓣连合切开术和主动脉瓣成形术一直被接受。气囊联合切开术已在世界各地成千上万的患者中使用，并在广泛的患者中提供了良好的短期和长期结果。在二尖瓣狭窄的治疗中，它实际上已经取代了外科分叉切开术。另一方面，经皮主动脉瓣膜成形术由于缺乏疗效和风险，在全球范围内几乎被放弃。新发现经皮瓣膜介入治疗的新技术是主动脉瓣置换术和二尖瓣修补术。两者都处于早期阶段，因为第一个In-man应用程序是在2002年才开始的。初步系列显示，这些技术是可行的；然而，必须与当代治疗方法相比较，进一步评估它们，以准确评估疗效和风险。今天，潜在的应用涉及高危患者，然而，在彻底评估后，这可能会在未来扩展到其他人。因此，经皮介入治疗已经在心脏瓣膜病的治疗中发挥了重要作用，而心脏瓣膜病在未来可能还会增长。
Purpose of review Since its introduction 27 years ago by Andreas Gruntzig, interventional cardiology has expanded its scope from coronary disease to peripheral, congenital, and also valve diseases. Percutaneous mitral commissurotomy and aortic valvuloplasty have been performed since the mid 1980s. Balloon commissurotomy has been used in tens of thousands of patients worldwide and provides good short- and long-term results in a wide range of patients. It has virtually replaced surgical commissurotomy in the management of mitral stenosis. On the other hand, percutaneous aortic valvuloplasty is almost abandoned worldwide due to its lack of efficacy and the risks involved. Recent findings The new techniques of percutaneous valve intervention are aortic valve replacement, and mitral valve repair. Both are at an early stage since the first in-man applications only started in 2002. Preliminary series show that these techniques are feasible; however, they must be further evaluated in comparison with contemporary treatment to accurately assess efficacy and risks. Today potential applications concern high-risk patients, however, after thorough evaluation this may be extended to others in the future. Summary Therefore, percutaneous interventions already play an important role in management of valvular heart disease, which is likely to grow in the future.