心脏瓣膜病介入治疗研究现状与发展趋势

Current research status and development trends of interventional therapy for valvular heart disease

摘要:

心脏瓣膜病已经成为全球心血管疾病负担的重要组成部分,其患病率随着人口老龄化持续攀升,治疗策略的选择对患者康复、并发症预防及延长生存期具有愈发重要的临床意义。目前传统外科手术仍是心脏瓣膜病的重要治疗方式,而近年来经导管介入技术的迅速发展,正深刻改变着心脏瓣膜病的临床治疗模式。2025年,欧洲心脏病学会(ESC)与欧洲心胸外科协会(EACTS)联合发布新版《瓣膜性心脏病管理指南》,指南中的多项关键更新进一步确立了介入治疗在瓣膜性心脏病整体管理策略中的重要地位。本文系统综述主动脉瓣、二尖瓣、三尖瓣及肺动脉瓣介入治疗的研究现状与最新技术进展,梳理各技术路径的适应证演变及其循证依据,并展望人工智能辅助决策、冲击波钙化重塑、新型高耐久材料等方向的未来发展,以期为临床决策和后续研究提供参考。

Abstract:

Valvular heart disease has become a significant component of the global cardiovascular disease burden, with its prevalence continuously rising as the population ages. The selection of treatment strategies holds increasing clinical importance for patient recovery, complication prevention, and prolonged survival. At present, traditional surgical procedures are still an important treatment for valvular heart disease, and in recent years, the rapid development of transcatheter intervention technology is profoundly changing the clinical treatment mode of valvular heart disease. In 2025, the European Society of Cardiology (ESC) and the European Association of Cardiothoracic Surgeons (EACTS) jointly released a new version of the “Guidelines for the Management of Valvular Heart Disease”. Several key updates in the guidelines further established the important role of interventional therapy in the overall management strategy of valvular heart disease. This article provides a systematic review of the current research status and latest technological advances in interventional therapy for aortic, mitral, tricuspid and pulmonary valves, summarizes the evolution of indications and evidence base of each technical pathway, and looks forward to the future development of artificial intelligence-assisted decision-making, shockwave mediated calcification remodeling, new high-durability materials, and other emerging directions, in order to provide a reference for clinical decision-making and subsequent research.