经导管主动脉瓣植入术进展综述

E. Koifman
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引用次数: 0

摘要

近年来,经导管主动脉瓣植入术(TAVI)已被证明是治疗需要瓣膜治疗的严重主动脉瓣狭窄患者的有效选择。TAVI最初被证明与外科主动脉瓣置换术(SAVR)相当,用于禁忌症和高手术风险的患者,逐渐扩展到中低风险患者,该装置已经发展和改进,具有更低的输送轮廓和更好的密封,以防止瓣旁泄漏,以及各种技术,如经颅、经腋和经颈动脉,使经皮治疗在具有挑战性的解剖结构中成为可能。此外,还开发了其他设备,通过在手术过程中预防中风和在通道关闭期间预防出血来提高患者安全。TAVI手术的这些进展转化为患者预后的改善,在低风险患者中TAVI优于SAVR,并将TAVI适应症扩展到具有挑战性的解剖结构和低风险患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Overview of Advances in Transcatheter Aortic Valve Implantation
In recent years, transcatheter aortic valve implantation (TAVI) has been shown to be a valid option of treatment for patients with severe aortic stenosis requiring valve therapy. Initially shown to be equivalent to surgical aortic valve replacement (SAVR) in prohibitive and high surgical risk patients, TAVI gradually expanded to intermediate and lower risk patients, the devices have evolved and improved with lower delivery profile and improved sealing to prevent paravalvular leak along with various techniques such as transcaval, transaxilary and transcarotid, enabling percutaneous treatment in challenging anatomies. In addition, additional devices were developed to improve patient safety by stroke prevention during the procedure and bleeding prevention during access closure. These advances in TAVI procedure were translated to improved patient outcome with superiority of TAVI over SAVR in low-risk patients and expansion of TAVI indication to challenging anatomies and lower risk patients.
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