[三尖瓣反流的跨学科治疗]。

IF 0.9 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Herz Pub Date : 2025-10-01 Epub Date: 2025-08-28 DOI:10.1007/s00059-025-05329-7
Marc Adrian Rogmann, Edoardo Zancanaro, Hendrik Treede, Philipp Lurz, Karl-Patrik Kresoja
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引用次数: 0

摘要

几十年来,三尖瓣反流(TR)被认为是临床上不重要的,经常不治疗。随着以导管为基础的治疗,特别是三尖瓣经导管边缘到边缘修复(T-TEER)的出现,该疾病得到了越来越多的临床关注和治疗势头。同时,外科治疗已经发展到对跳动的心脏进行微创内窥镜手术。本文探讨了跨学科心脏团队在T - TEER或手术治疗的评估和执行中的作用。基于当前的指导方针,临床试验数据和超声心动图选择标准,它分析了一个结构化的,跨学科的决策过程的需要。成功的TR管理需要广泛的跨学科专业知识,包括心力衰竭管理、心脏成像、介入性心脏病学和心脏外科。使用tri评分和基于成像的评分系统等经过验证的工具进行结构化风险评估,可以对预后和解剖适应性进行客观评估。一个关键的临床挑战仍然是确定干预的最佳时机,在不可逆的右心室功能恶化或终末器官损伤发生之前。总之,如果没有一个功能良好的心脏团队,为严重TR提供高质量、以患者为中心的护理几乎是不可能实现的。早期转诊,密切配合门诊心脏病专家,和全面的成像是必不可少的,以实现有利的和可持续的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Interdisciplinary management of tricuspid valve regurgitation].

For decades tricuspid valve regurgitation (TR) was considered clinically insignificant and often left untreated. Only with the emergence of catheter-based treatment, particularly tricuspid transcatheter edge-to-edge repair (T-TEER), the condition has gained increasing clinical attention and therapeutic momentum. Concurrently, the surgical treatment has evolved towards minimally invasive endoscopic operations on the beating heart. This article explores the role of the interdisciplinary heart team in the evaluation and execution of T‑TEER or surgical treatment. Based on current guidelines, clinical trial data and echocardiographic selection criteria, it analyses the need for a structured, interdisciplinary decision-making process. Successful TR management requires broad interdisciplinary expertise, including heart failure management, cardiac imaging, interventional cardiology and cardiac surgery. Structured risk assessments using validated tools such as the TRI-score and imaging-based scoring systems enable an objective evaluation of prognosis and anatomical suitability. A key clinical challenge remains the identification of the optimal timing for an intervention, before irreversible deterioration of the right ventricular function or end-organ damage occurs. In conclusion, delivering high-quality, patient-centred care for severe TR is barely achievable without a well-functioning heart team. Early referral, close coordination with outpatient cardiologists, and comprehensive imaging are essential to achieving favourable and sustainable outcomes.

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来源期刊
Herz
Herz 医学-心血管系统
CiteScore
3.00
自引率
5.90%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.
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