Non-pharmacologic Management of Structural Heart Disease

以非藥物的方式治療結構性心臟病

李應湘(Ying-Hsiang Lee) ； 林柏霖(Po-Lin Lin) ； 邱威儒(Wei-Ru Chiou) ； 廖峰慶(Feng-Ching Liao) ； 張盛雄(Sheng-Hsiung Chang) ； 郭任遠(Jen-Yuan Kuo) ； 侯嘉殷(Charles Jia-Yin Hou)

《內科學誌》 28卷4期 (2017/08) Pp. 218-222

https://doi.org/10.6314/JIMT.2017.28(4).04

摘要

Structural heart disease is defined as malfunction of heart valves, chambers, and contractility strongly associated with prognosis, life expectancy, and quality of life. It also refers to non-coronary cardiovascular disease processes and related interventions. The last twenty years, the percutaneous therapeutic modalities and processes has seen tremendous advances. In addition, the emerging evidence via clinical trials are helping to accomplish patient or therapy selection properly. Inherent challenges exist in training physicians, supportive medical affairs and paramedical systems. Ultimately, credentialing societies and training programmes will emerge to help assure expertise within the cardiovascular community. This review focuses on the update of left atrial appendage occluder, transcatheter mitral valve repair, and transcatheter aortic valve replacement. At the end, the challenges unique to structural heart disease would be introduced for future directions.

關鍵字

Structural heart disease ； LAAO ； TMVR ； TAVI

並列摘要

結構性心臟病一詞通常被用來泛指心臟瓣膜，心腔室和收縮異常相關之心臟疾病；其預後與壽命和生活品質高度密切。它也常被當作非冠狀動脈心臟病介入治療的標的疾病。在過去二十年間，經皮介入治療方式有了長足進步，也經由臨床試驗得到新證據，幫助醫師做治療上的選擇，但仍需相關的認證機構和培訓計劃來確保結構性心臟病的專業知識。如何有效完成人員培訓，技術支援和非臨床系統整合，將扮演具足輕重的角色。本綜述重點在介紹左心耳封堵術，經導管二尖瓣修復手術和經導管心臟主動脈瓣膜置換手術的最新資料。