Vogt F, Wicklein S, Singler K, Pfeiffer S, Fischlein T, Schwab J, Pauschinger M, Jessl J
Klinik für Herzchirurgie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Breslauer Str. 201, 90471, Nürnberg, Deutschland.
Medizinische Klinik 2, Schwerpunkt Geriatrie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland.
Z Gerontol Geriatr. 2016 Oct;49(7):639-656. doi: 10.1007/s00391-016-1112-3. Epub 2016 Aug 12.
The treatment of severe symptomatic aortic valve stenosis by conventional aortic valve replacement (AVR) or by transcatheter aortic valve implantation (TAVI) has a good perinterventional prognosis even for patients of advanced age. Having a heart team select the best management strategies based on current guidelines for each individual patient is essential for success. Especially in elderly and increasingly multimorbid patients with sometimes severe preconditions, the detection of functional deficits is relevant not only for the mortality but also for perioperative and postoperative complications as well as the functional outcome. Various methods of geriatric assessment are important supplements to standard risk scores. The aim is to implement targeted interventions to minimize the risk factors and to improve the prognosis for elderly patients. The aim of this article is to provide an overview of the current therapy options for aortic valve replacement and to summarize current aspects of treatment options for elderly patients.
对于重度有症状的主动脉瓣狭窄患者，采用传统主动脉瓣置换术（AVR）或经导管主动脉瓣植入术（TAVI）治疗，即使对于高龄患者，围介入期预后也较好。由心脏团队根据当前指南为每位患者选择最佳管理策略是成功的关键。特别是在老年且合并症日益增多、有时存在严重基础疾病的患者中，功能缺陷的检测不仅与死亡率相关，还与围手术期和术后并发症以及功能结局相关。各种老年评估方法是标准风险评分的重要补充。目的是实施有针对性的干预措施，以最小化风险因素并改善老年患者的预后。本文旨在概述当前主动脉瓣置换的治疗选择，并总结老年患者治疗选择的当前方面。
