Holzer Ralf J, Hijazi Ziyad M
Cardiac Catheterization and Interventional Therapy, Division Chief Cardiology (Acting), Sidra Cardiovascular Center of Excellence, Sidra Medical and Research Center, Doha, Qatar.
Weill Cornell Medical College, Chief Medical Officer (Acting), Chair, Department of Pediatrics, Director, Sidra Cardiovascular Center of Excellence, Sidra Medical and Research Center, Doha, Qatar.
Catheter Cardiovasc Interv. 2016 Jan 1;87(1):117-28. doi: 10.1002/ccd.26263. Epub 2015 Oct 1.
The number of patients undergoing transcatheter pulmonary valve replacement has been steadily increasing, resulting in many research projects focusing on this patient population. This has highlighted the need to summarize the currently available data.
A review of the literature was conducted and the results summarized.
At present, the two commercially available valves approved for transcatheter pulmonary valve replacement include the Edwards Sapien valve and the Medtronic Melody valve. More data has been published relating to the Melody valve; this included the incidence of coronary anatomy prohibiting valve implantation of 5%, an incidence of conduit disruption of 6%, and freedom from stent fracture of the Melody valve stent of 60% at 30 months. Short and medium term outcomes seem to be comparable if not superior to surgical valve replacement, but long-term data is still lacking. There may also be a cost benefit with transcatheter valve implantation when compared to surgical pulmonary valve replacement.
Transcatheter pulmonary valve replacement is here to stay. The main challenge of treating patients with a native right ventricular outflow tract still needs to be addressed and device development efforts centered in this area. © 2015 Wiley Periodicals, Inc.
接受经导管肺动脉瓣置换术的患者数量一直在稳步增加，这导致许多研究项目聚焦于这一患者群体。这凸显了总结当前可用数据的必要性。
进行了文献综述并总结了结果。
目前，已获批用于经导管肺动脉瓣置换术的两种商用瓣膜包括爱德华兹Sapien瓣膜和美敦力Melody瓣膜。关于Melody瓣膜已发表了更多数据；这包括冠状动脉解剖结构禁止瓣膜植入的发生率为5%，管道破裂的发生率为6%，以及Melody瓣膜支架在30个月时无支架骨折的比例为60%。短期和中期结果似乎与外科瓣膜置换术相当，甚至可能更优，但长期数据仍然缺乏。与外科肺动脉瓣置换术相比，经导管瓣膜植入术可能也具有成本效益。
经导管肺动脉瓣置换术已成为现实。治疗天然右心室流出道患者的主要挑战仍需解决，并且该领域的器械研发工作应以此为核心。© 2015威利期刊公司
