Costopoulos Charis, Sutaria Nilesh, Ariff Ben, Fertleman Michael, Malik Iqbal, Mikhail Ghada W
Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK.
Expert Rev Cardiovasc Ther. 2015 May;13(5):457-60. doi: 10.1586/14779072.2015.1036742. Epub 2015 Apr 12.
Aortic valve stenosis is the commonest encountered valvular pathology and a frequent cause of morbidity and mortality in cases of severe stenosis. Definitive treatment has traditionally been offered in the form of surgical aortic valve replacement in patients with an acceptable surgical risk and more recently with the less invasive transcatheter aortic valve implantation (TAVI) in those where surgery is not a viable option. Prior to the introduction of TAVI, inoperable patients were treated medically and where appropriate with balloon aortic valvuloplasty, a procedure which although effective only provided short-term relief and was associated with high complication rates especially during its infancy. Here we discuss whether balloon aortic valvuloplasty continues to have a role in contemporary clinical practice in an era where significant advances have been achieved in the fields of surgical aortic valve replacement, TAVI and postoperative care.
主动脉瓣狭窄是最常见的瓣膜病变,也是重度狭窄病例中发病和死亡的常见原因。传统上,对于手术风险可接受的患者,确定性治疗方式是进行外科主动脉瓣置换术,最近,对于那些手术不可行的患者,则采用侵入性较小的经导管主动脉瓣植入术(TAVI)。在TAVI引入之前,无法手术的患者接受药物治疗,并在适当情况下进行球囊主动脉瓣成形术,该手术虽然有效,但只能提供短期缓解,且并发症发生率高,尤其是在其发展初期。在此,我们讨论在外科主动脉瓣置换术、TAVI和术后护理领域已取得重大进展的时代,球囊主动脉瓣成形术在当代临床实践中是否仍有作用。