The Heart Hospital, University College London Hospitals UCLH, 16-18 Westmoreland Street, London, UK.
Heart. 2012 Dec;98(23):1701-9. doi: 10.1136/heartjnl-2012-302569. Epub 2012 Sep 2.
The field of interventional cardiology continues to progress quickly. The efficacy of percutaneous interventions with newer generation drug-eluting stents has advanced a lot over the last decade. This improvement in stent performance has broadened the level of indication towards more complex interventions such as left main and multi-vessel PCI. Major improvements continue in the field of medical co-therapy such as antiplatelet therapies (bivalirudin, prasugrel, ticagrelor) and this will further improve outcomes of PCI. The same is true for intravascular imaging such as ultrasound IVUS and optical coherence tomography OCT. However, interventional cardiology has become a rather broad field, also including alcohol septal ablation for hypertrophic obstructive cardiomyopathy, etc. At the moment, the fastest growing area is the structural interventions, especially for aortic valve stenosis (transcatheter aortic valve implantation TAVI) and for mitral regurgitation (mitral clipping). This review covers recent advances in all these different fields of interventional cardiology.
介入心脏病学领域继续快速发展。在过去十年中,新一代药物洗脱支架的经皮介入治疗的疗效有了很大提高。支架性能的这种改善拓宽了更复杂干预措施的适应证范围,如左主干和多血管 PCI。抗血小板治疗(比伐卢定、普拉格雷、替格瑞洛)等医学联合治疗领域的重大进展也将进一步改善 PCI 的结果。血管内成像(如超声 IVUS 和光学相干断层扫描 OCT)也是如此。然而,介入心脏病学已经成为一个相当广泛的领域,也包括肥厚型梗阻性心肌病的酒精室间隔消融术等。目前,增长最快的领域是结构性介入治疗,特别是用于主动脉瓣狭窄(经导管主动脉瓣植入术 TAVI)和二尖瓣反流(二尖瓣夹合术)。这篇综述涵盖了介入心脏病学所有这些不同领域的最新进展。