Himbert Dominique, Vahanian Alec
Department of Cardiology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris 75018, France.
Department of Cardiology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, 46 Rue Henri Huchard, Paris 75018, France.
Heart Fail Clin. 2015 Apr;11(2):231-42. doi: 10.1016/j.hfc.2014.12.003. Epub 2015 Feb 18.
Older patients suffering severe heart failure related to aortic stenosis (AS) undergo transcatheter aortic valve replacement (TAVR), owing to their high surgical risk. The diagnosis is made based on echocardiographic examination, but may require a multimodality imaging approach in patients with low gradients. In severely decompensated heart failure or cardiogenic shock, rescue percutaneous balloon aortic valvuloplasty as a bridge to TAVR seems reasonable. Emergent TAVR has been reported. Efforts should be made to avoid late diagnosis or referring patients with severe AS to offer them timely interventions, reduce the risk of TAVR, and predict whether left ventricular function will improve.
患有与主动脉瓣狭窄（AS）相关的严重心力衰竭的老年患者，由于手术风险高，会接受经导管主动脉瓣置换术（TAVR）。诊断基于超声心动图检查，但对于低梯度患者可能需要多模态成像方法。在严重失代偿性心力衰竭或心源性休克中，抢救性经皮球囊主动脉瓣成形术作为TAVR的桥梁似乎是合理的。已有紧急TAVR的报道。应努力避免漏诊或转诊严重AS患者，以便为他们提供及时干预，降低TAVR风险，并预测左心室功能是否会改善。
