Möllmann H, Kim W-K, Walther T, Hamm C
Abteilung für Kardiologie, Kerckhoff-Klinik Bad Nauheim, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland,
Internist (Berl). 2013 Dec;54(12):1469-81; quiz 1482-3. doi: 10.1007/s00108-013-3382-9.
Aortic valve stenosis (AS) is the most common acquired valve disease in the industrialized countries. Most patients--especially young and low-risk patients--can be safely and effectively operated with aortic valve replacement. Due to increasing life expectancy, however, the number of elderly patients with AS and various concomitant diseases will increase in the coming decades. For those elderly high-risk patients, transfemoral or transapical aortic valve implantation (TAVI) has evolved as a valuable alternative to conventional surgery. The TAVI approach has been shown to be superior to standard medical treatment in these high-risk patients. All patients considered for TAVI should be discussed in a consensus conference consisting of cardiac surgeons and cardiologists (heart team). Furthermore, for successful treatment with transcatheter techniques, sophisticated pre-interventional imaging is required to screen patients. Available data on TAVI from randomized trials and large-scale registries demonstrate that this method is very promising.
主动脉瓣狭窄(AS)是工业化国家最常见的后天性瓣膜疾病。大多数患者——尤其是年轻和低风险患者——可通过主动脉瓣置换术安全有效地进行手术。然而,由于预期寿命的增加,未来几十年患有AS和各种合并症的老年患者数量将会增加。对于那些老年高危患者,经股动脉或经心尖主动脉瓣植入术(TAVI)已发展成为传统手术的一种有价值的替代方法。在这些高危患者中,TAVI方法已被证明优于标准药物治疗。所有考虑进行TAVI的患者都应在由心脏外科医生和心脏病专家组成的共识会议(心脏团队)上进行讨论。此外,为了通过导管技术成功治疗,需要先进的介入前成像来筛选患者。来自随机试验和大型登记处的关于TAVI的现有数据表明,这种方法非常有前景。