Aortic Valve Intervention in Patients with Aortic Stenosis and Small Annulus.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2025-03-24 eCollection Date: 2025-03-01 DOI:10.31083/RCM26738
Ahmed Abdalwahab, Muntaser Omari, Mohammad Alkhalil
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Abstract

Over the last two decades, the management of aortic stenosis has undergone significant transformation due to developments in surgical techniques and the introduction of transcatheter aortic valve implantation (TAVI). These transformations have enabled improved patient selection and treatments to be tailored based on individual clinical and anatomical characteristics. Both surgical and transcatheter options have resulted in reduced mortality and enhanced quality of life for patients with aortic stenosis. Nonetheless, treating patients with small aortic annulus remains challenging despite advances in current technology. The insertion of a small prosthetic valve, leading to patient prosthetic mismatch, has been associated with heart failure hospitalization, early structural valve degeneration, and long-term mortality. Although aortic root enlargement was historically employed to address this issue, stentless and sutureless valves in the supra-annular position and, more recently, TAVI have emerged as alternative treatments for patients with small annulus and severe aortic stenosis. This review will provide an overview of the prevalence and anatomical characteristics of patients with aortic stenosis and small annulus. Additionally, we will discuss current treatment options, including surgery and TAVI, used to mitigate procedural and long-term adverse outcomes in this group.

主动脉狭窄伴小环患者主动脉瓣介入治疗。
在过去的二十年中,由于外科技术的发展和经导管主动脉瓣植入术(TAVI)的引入,主动脉瓣狭窄的治疗发生了重大变化。这些转变使患者的选择和治疗能够根据个人临床和解剖特征进行调整。手术和经导管治疗均可降低主动脉瓣狭窄患者的死亡率,提高患者的生活质量。然而,尽管目前的技术进步,治疗小主动脉环患者仍然具有挑战性。植入一个小的人工瓣膜,导致患者假体不匹配,与心力衰竭住院、早期结构性瓣膜变性和长期死亡率有关。虽然主动脉根部扩大历来被用于解决这个问题,但在环上位置的无支架和无缝合线瓣膜以及最近的TAVI已成为小环和严重主动脉狭窄患者的替代治疗方法。本文将对主动脉狭窄伴小环的患者的患病率和解剖学特征进行综述。此外,我们将讨论当前的治疗方案,包括手术和TAVI,用于减轻该组的程序性和长期不良后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
期刊介绍: RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.
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