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高龄与经导管主动脉瓣植入术的临床结局。

Advanced age and the clinical outcomes of transcatheter aortic valve implantation.

机构信息

Department of Internal Medicine, Michigan State University, B-301 Clinical Center, East Lansing, MI 48824, USA.

出版信息

J Geriatr Cardiol. 2014 Jun;11(2):163-70. doi: 10.3969/j.issn.1671-5411.2014.02.004.

Abstract

Aortic valve stenosis (AS) is common in the elderly. Although surgical replacement of the valve has been the gold standard of management, many patients have been excluded from surgery because they were very old, frail, or had co-morbidities that increased operative risks. In the last decade, transcatheter aortic valve implantation (TAVI) has emerged as a new treatment option suitable for these patients. This article reviews the available literature on the role of TAVI in elderly patients with severe aortic stenosis. Published studies showed that elderly individuals who underwent TAVI experienced better in-hospital recovery, and similar short and mid-term mortality compared to those underwent surgical treatment of AS. However, long-term outcomes of TAVI in elderly patients are still unknown. The available data in the literature on the effect of advanced age on clinical outcomes of TAVI are limited, but the data that are available suggest that TAVI is a beneficial and tolerable procedure in very old patients. Some of the expected complications after TAVI are reported more in the oldest patients such as vascular injures. Other complications were comparable in TAVI patients regardless of their age group. However, very old patients may need closer monitoring to avoid further morbidities and mortality.

摘要

主动脉瓣狭窄(AS)在老年人中很常见。尽管瓣膜置换术一直是治疗的金标准,但由于患者年龄非常大、身体虚弱或存在增加手术风险的合并症,许多患者已被排除在手术之外。在过去十年中,经导管主动脉瓣植入术(TAVI)已成为适合这些患者的新治疗选择。本文回顾了关于 TAVI 在老年重度主动脉瓣狭窄患者中的作用的现有文献。已发表的研究表明,接受 TAVI 的老年患者在院内恢复情况更好,与接受 AS 手术治疗的患者相比,短期和中期死亡率相似。然而,TAVI 对老年患者的长期疗效尚不清楚。目前文献中关于高龄对 TAVI 临床结局影响的数据有限,但现有数据表明,TAVI 对非常高龄的患者是一种有益且可耐受的手术。TAVI 后一些预期的并发症在最年长的患者中更为常见,例如血管损伤。其他并发症在 TAVI 患者中无论年龄组如何都相似。然而,非常高龄的患者可能需要更密切的监测,以避免进一步的并发症和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a64c/4076458/86d498e18bc5/jgc-11-02-163-g001.jpg

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