功能性三尖瓣关闭不全的治疗现状

Current status of treatment for functional tricuspid regurgitation

摘要:

临床对功能性的三尖瓣关闭不全（FTR）并没有足够重视，总是期望其随着左心系统疾病的治愈而自愈。目前随着对右心系统功能、病变等认识的不断进步，FTR被认为是心脏疾病发病率和病死率升高的重要原因，临床治疗也越来越积极和主动。该文从三尖瓣解剖结构、左心系统疾病对其的影响等方面分析了FTR产生的原因，描述出现FTR后的临床表现，比较FTR严重程度的判定和测量标准，阐明FTR的预后，并总结当前临床FTR的主要治疗手段。提出FTR是其他疾病在不断进展的过程中引发的右心系统继发性改变等综合因素，导致三尖瓣出现一种相对独立的、新的病变。希望能引起心脏外科医生们的重视，并尽早进行适当的外科干预。

Abstract:

Clinical attention to functional tricuspid regurgitation (FTR) has been insufficient, with a common expectation that it will resolve spontaneously following the treatment of left heart diseases. With the ongoing advancements in understanding the right heart function and pathology, FTR is now recognized as a significant contributor to increased morbidity and mortality among cardiac diseases. As a result, clinical treatment for FTR has become increasingly proactive and aggressive. This review analyzes the causes of FTR from perspectives such as the anatomical structure of the tricuspid valve and the impact of left heart diseases. It describes the clinical manifestations of FTR, compares the criteria and measurement standards for assessing its severity, clarifies its prognosis, and summarizes the main clinical treatment approaches currently available for FTR. We propose that FTR is a relatively independent and emerging pathological condition of the tricuspid valve, resulting from secondary changes in the right heart caused by the progressive development of other diseases. We hope to draw the attention of cardiac surgeons to this condition and advocate for timely and appropriate surgical intervention.