重度二尖瓣逆流治療的新技術－－經導管二尖瓣修補術及護理

Percutaneous Edge-to-Edge Mitral Valve Repair: New Transcatheter Approach and Nursing Experience in Patients With Severe Mitral Regurgitation and Prohibitive Surgical Risk

重度二尖瓣逆流的治療，以往是以傳統開心手術及保守藥物治療為主，而經導管二尖瓣膜修補術則是一項新發展的技術，主要是利用心導管的方 式，遞送二尖瓣膜夾來夾合閉鎖不全的二尖瓣， 以改善二尖瓣逆流造成的心臟衰竭症狀與預後。 國外已有許多研究證明，此介入性治療方式與傳 統二尖瓣開心手術比較，對於二尖瓣膜逆流的病 患有較低的手術相關併發症發生比率，亦可有效改善血液逆流的程度，進而改善心臟衰竭的嚴重度，是二尖瓣逆流達中重度以上手術高風險患者的一項新的選擇，國內於2016年引入此項新治療的方式，本文主要為簡介此項新治療方式及彙整護理照顧重點，以提供臨床照顧參考。

Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications. Since 2016, MitraClip has been available for clinical use in Taiwan. The aim of this report is to introduce this new treatment with a focus on nursing care in order to provide a reference for clinical care.