Gregg W. Stone    哥伦比亚大学医学中心

　　对功能性二尖瓣关闭不全患者，手术治疗并未显示良好效果，目前药物治疗、保守治疗或心脏再同步化治疗仍是其主要的标准治疗措施。近年来，随着经导管瓣膜治疗的飞速发展，MitraClip这一新技术为功能性二尖瓣关闭不全患者提供了一种新的治疗方法。在100例患者的应用结果提示，MitraClip可使患者感觉更好，促进左室负性重构，增强心肌收缩，降低住院率，为患者带来显著获益。目前尚无有关该技术的随机对照试验，亟需开展相关试验进一步验证MitraClip治疗功能性二尖瓣关闭不全的有效性及优越性，以确定是否应在众多患者常规推广应用。目前正在开展的COAPT试验将为我们带来这方面的最新数据。

　　As we know， surgery has never been shown to be of major advantage for functional mitral regurgitation. Thus， medical therapy， conservative care or sometimes cardiac resynchronization therapy are the standard of care. In recent years， transcatheter valve therapy has seen rapid growth and development. The new technology known as MitraClip provides a new treatment approach for functional mitral regurgitation. In a series of several hundred patients， the MitraClip looks like it can make patients feel better， promotes negative remodeling of the left ventricle， (i.e. enhances the contraction of the ventricle) and decreases the hospitalization rate. All these results indicate that it is favorable and promising. The only problem is that there are still no randomized trials looking at MitraClip. Therefore， we need to carry out such trials to further confirm its effectiveness and advantages to provide evidence for whether we should uniformly apply this new technology to the hundreds-of-thousands of patients with functional mitral regurgitation. The ongoing COAPT trial will bring new evidence for us in the future.