Ielasi Alfonso, Latib Azeem, Tespili Maurizio
Cardiology Division, Azienda Ospedaliera "Bolognini", Seriate (BG), Italy.
Expert Rev Cardiovasc Ther. 2013 Oct;11(10):1393-405. doi: 10.1586/14779072.2013.837702.
Transcatheter aortic valve implantation (TAVI) has become an accepted treatment option for patients with symptomatic severe aortic stenosis who are at high risk for traditional surgical aortic valve replacement. In particular, TAVI has been shown to reduce mortality in a randomized comparison with medical treatment and to be non-inferior to surgical aortic valve replacement in 'high-risk operable' patients. From its early stages it became apparent that TAVI has tremendous potential and thus considerable efforts were made to design new devices and advance valve technology in order to improve outcomes and increase TAVI applications in complex anatomies and in patients with multiple co-morbidities. In this review, we present the advances in transcatheter aortic valve technology and discuss the current evidence on the new-generation TAVI devices.
经导管主动脉瓣植入术(TAVI)已成为有症状的严重主动脉瓣狭窄患者的一种公认治疗选择,这些患者接受传统外科主动脉瓣置换术的风险很高。特别是,与药物治疗相比,TAVI已被证明可降低死亡率,并且在“高风险可手术”患者中不劣于外科主动脉瓣置换术。从早期阶段开始就很明显,TAVI具有巨大潜力,因此人们付出了巨大努力来设计新设备并推进瓣膜技术,以改善治疗效果并增加TAVI在复杂解剖结构和患有多种合并症患者中的应用。在本综述中,我们介绍经导管主动脉瓣技术的进展,并讨论关于新一代TAVI设备的当前证据。