Dvir Danny, Barbanti Marco, Tan John, Webb John G
Curr Probl Cardiol. 2014 Jan;39(1):7-27. doi: 10.1016/j.cpcardiol.2013.10.001. Epub 2013 Oct 24.
Most surgical heart valves currently implanted are bioprosthetic tissue valves. Such valves deteriorate with time, eventually presenting with either stenosis or regurgitation. Reoperation, the current standard of care for failed valves, carries significant risk in terms of both morbidity and mortality. Implantation of a transcatheter valve inside a failed surgical valve (valve-in-valve procedure) has recently emerged as an alternative, less-invasive option. Although the procedure is similar in some aspects to transcatheter aortic valve implantation in the setting of native aortic valve stenosis, there are many differences that deserve special consideration. We review the potential and challenges of valve-in-valve implantation in patients with failing surgical aortic bioprostheses.
目前植入的大多数外科心脏瓣膜是生物假体组织瓣膜。这类瓣膜会随着时间推移而退化,最终出现狭窄或反流。再次手术是目前针对功能失效瓣膜的标准治疗方法,在发病率和死亡率方面都存在重大风险。在功能失效的外科瓣膜内植入经导管瓣膜(瓣中瓣手术)最近已成为一种替代的、侵入性较小的选择。尽管该手术在某些方面与在原发性主动脉瓣狭窄情况下进行的经导管主动脉瓣植入术相似,但仍有许多差异值得特别考虑。我们综述了在功能失效的外科生物主动脉瓣膜患者中进行瓣中瓣植入的潜力和挑战。
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