Al-Najafi Saif, Sanchez Frank, Lerakis Stamatios
Department of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Curr Treat Options Cardiovasc Med. 2016 Dec;18(12):70. doi: 10.1007/s11936-016-0497-z.
Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data. We believe that the key for a successful TAVR is careful pre-procedural planning and early detection of any possible post-implantation complications. To achieve this, multimodality imaging is cornerstone. Throughout the stages of patient-evaluation, echocardiography and computed tomography play complementary roles. MRI, on the other hand, has emerged as a useful tool in quantifying post-implantation paravalvular regurgitation.
在过去20年里,经导管瓣膜介入治疗已成为结构性心脏病领域最重要的进展之一。最初,这些介入治疗针对的是重度主动脉瓣狭窄且手术风险高的患者;然而,其应用范围已扩展至其他天然瓣膜病变、人工瓣膜退化以及手术风险较低的患者。在本文中,我们通过探讨当前的实践、指南和建议以及支持数据,讨论心脏成像在经导管主动脉瓣置换术(TAVR)中的重要性。我们认为,成功进行TAVR的关键在于仔细的术前规划以及早期发现任何可能的植入后并发症。要做到这一点,多模态成像至关重要。在患者评估的各个阶段,超声心动图和计算机断层扫描发挥着互补作用。另一方面,MRI已成为量化植入后瓣周反流的有用工具。