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经导管心脏瓣膜:特殊特性与潜在缺点

Transcatheter Heart Valves: Specific Characteristics and Potential Shortcomings.

作者信息

Blumenstein J, Van Linden A, Moellmann H, Walther T, Kempfert J

机构信息

Department of Cardiac Surgery, Kerckhoff Heart-Center, Benekestrasse 2-8, 61231 Bad Nauheim, Germany.

出版信息

Curr Cardiol Rev. 2013 Dec 2.

Abstract

During the past years TAVI has evolved to a standard technique for the treatment of high risk patients suffering from severe aortic stenosis. Worldwide the number of TAVI procedures is increasing exponentially. In this context both the transapical antegrade (TA) and the transfemoral retrograde (TF) approach are predominantly used and can be considered as safe and reproducible access sites for TAVI interventions. As a new technology TAVI is in a constant progress regarding the development of new devices. While in the first years only the Edwards SAPIEN™ and the Medtronic CoreValve™ prostheses were commercial available, recently additional devices obtained CE-mark approval and others have entered initial clinical trials. In addition to enhance the treatment options in general, the main driving factor to further develop new device iterations is to solve the drawbacks of the current TAVI systems: paravalvular leaks, occurrence of AV-blocks and the lack of full repositionability.

摘要

在过去几年中,经导管主动脉瓣植入术(TAVI)已发展成为治疗患有严重主动脉瓣狭窄的高危患者的标准技术。在全球范围内,TAVI手术的数量呈指数级增长。在这种情况下,经心尖顺行(TA)和经股逆行(TF)方法都被广泛使用,并且可以被视为TAVI干预的安全且可重复的入路部位。作为一项新技术,TAVI在新设备的开发方面一直在不断进步。在最初几年,只有爱德华兹SAPIEN™和美敦力CoreValve™假体可商业化使用,最近又有其他设备获得了CE标志批准,还有一些已进入初步临床试验。除了总体上增加治疗选择外,进一步开发新设备迭代的主要驱动因素是解决当前TAVI系统的缺点:瓣周漏、房室传导阻滞的发生以及缺乏完全可重新定位性。

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