Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA.
Eur Heart J. 2012 Oct;33(19):2399-402. doi: 10.1093/eurheartj/ehs223. Epub 2012 Jul 31.
Transcatheter aortic valve implantation (TAVI) has been increasingly recognized as a curative treatment for severe aortic stenosis (AS). Despite important improvements in current device technology and implantation techniques, specific complications still remain and warrant consideration. Vascular complications and peri-procedural neurological events were the first concerns to emerge with this new technology. Recently, significant post procedural para-valvular leak has been shown to be more frequent after TAVI than after surgical aortic valve replacement (SAVR), and its potential association with worse long-term prognostic has raised concerns. In moving toward treatment of lower risk populations, structural integrity and long-term durability of heat valve prosthesis are becoming of central importance. Emerging technologies and newer generations of devices seem promising in dealing with these matters.
经导管主动脉瓣植入术(TAVI)已被越来越多地认为是治疗严重主动脉瓣狭窄(AS)的一种根治方法。尽管目前的设备技术和植入技术有了重要的改进,但仍存在一些特定的并发症,需要加以考虑。血管并发症和围手术期神经事件是这项新技术首先出现的问题。最近,与外科主动脉瓣置换术(SAVR)相比,TAVI 后发生明显的瓣周漏的情况更为常见,其与长期预后恶化的潜在相关性引起了人们的关注。随着向低危人群治疗的推进,热瓣假体的结构完整性和长期耐久性变得越来越重要。新兴技术和新一代设备在处理这些问题方面似乎很有前景。