Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
J Am Coll Cardiol. 2015 Nov 3;66(18):2019-2037. doi: 10.1016/j.jacc.2015.09.015.
Bioprosthetic valve use has increased significantly. Considering their limited durability, there will remain an ongoing clinical need for repairing or replacing these prostheses in the future. The current standard of care for treating bioprosthetic valve degeneration involves redo open-heart surgery. However, repeat cardiac surgery may be associated with significant morbidity and mortality. With the rapid evolution of transcatheter heart valve therapies, the feasibility and safety of implanting a transcatheter heart valve within a failed tissue valve has been established. We review the historical perspective of transcatheter valve-in-valve therapy, as well as the main procedural challenges and clinical outcomes associated with this new less invasive treatment option.
生物瓣的使用显著增加。考虑到其耐用性有限，未来仍将需要对这些假体进行修复或更换。目前，治疗生物瓣退行性变的标准治疗方法是再次进行开胸心脏手术。然而，重复心脏手术可能会导致严重的发病率和死亡率。随着经导管心脏瓣膜治疗的快速发展，在失败的组织瓣膜内植入经导管心脏瓣膜的可行性和安全性已经得到证实。我们回顾了经导管瓣中瓣治疗的历史，以及与这种新的微创治疗选择相关的主要程序挑战和临床结果。
