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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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Enfermedad de la válvula mitral: tratamiento actual y desafíos futuros

Rick A Nishimura1, Alec Vahanian2, Mackram F Eleid1

  • 1Mayo Clinic, Rochester, MN, USA.

Lancet (London, England)
|March 31, 2016
PubMed
Resumen

El manejo de la enfermedad de la válvula mitral está evolucionando con imágenes avanzadas y tratamientos como la reparación quirúrgica y la reparación de la válvula mitral transcatéter (MitraClip). Las direcciones futuras se centran en optimizar la atención para la regurgitación mitral primaria y secundaria, incluidas las técnicas transcatéter.

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Área de la Ciencia:

  • Cardiología
  • Cirugía cardíaca
  • Cardiología intervencionista

Sus antecedentes:

  • El diagnóstico y el tratamiento de la enfermedad de la válvula mitral están avanzando rápidamente.
  • La mejora de las imágenes y la comprensión de la patología permiten un diagnóstico más temprano y tratamientos complejos.
  • El manejo de la regurgitación mitral primaria se centra en la reparación quirúrgica, mientras que la regurgitación mitral secundaria presenta un futuro menos claro.

Objetivo del estudio:

  • Revisar el estado actual y las direcciones futuras en el diagnóstico y tratamiento de la enfermedad de la válvula mitral.
  • Para resaltar los avances en las intervenciones quirúrgicas y transcatéter para la regurgitación mitral.
  • Para discutir los desafíos y los tratamientos emergentes para la calcificación anular mitral.

Principales métodos:

  • Revisión de la literatura actual y de los resultados de los ensayos clínicos.
  • Análisis de las modalidades de tratamiento establecidas y emergentes para la regurgitación mitral.
  • Discusión del papel de las imágenes en la evaluación de la enfermedad de la válvula mitral.

Principales resultados:

  • La reparación quirúrgica sigue siendo el estándar para la regurgitación mitral primaria, con altas tasas de éxito esperadas.
  • La reparación de la válvula mitral transcatéter (MitraClip) es prometedora para pacientes de alto riesgo y se está estudiando en grupos de riesgo intermedio.
  • Se espera que las técnicas de transcatéter para la reparación y el reemplazo se expandan, especialmente para la calcificación anular mitral.

Conclusiones:

  • Es probable que en los próximos cinco años se optimice la reparación quirúrgica para la regurgitación mitral primaria y se amplíe el uso de intervenciones transcatéter.
  • Los ensayos clínicos adicionales son cruciales para aclarar las estrategias de manejo de la regurgitación mitral secundaria.
  • Los enfoques transcatéter ofrecen nuevas posibilidades para el tratamiento de la enfermedad de la válvula mitral compleja, incluida la calcificación anular mitral.