Cardiology Department, University Clinical Center of Serbia, Belgrade, Serbia.
Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium.
Curr Pharm Des. 2017;23(31):4687-4695. doi: 10.2174/1381612822666161018162022.
Efforts to develop and refine percutaneous approaches to cardiac valve repair and replacement have advanced rapidly over the past several years, having exceeded even the most optimistic expectations. New innovations have been predominantly directed toward the most frequent form of valvular heart disease (VHD) in the industrialized world; aortic stenosis (AS). Approximately 250,000 transcatheter aortic valve implantation (TAVI) procedures have been done so far addressing this significant medical need. Because of the predominance of degenerative etiologies, the prevalence of VHD increases markedly in population above the age of 65 years, in particular with regard to severe AS. As the populations of the industrialized countries continue to be older, the need for less invasive and safer methods of treating severe AS will continue to grow. In this review we provide comprehensive and up-to-date overview of TAVI in current clinical practice. We have also addressed dilemmas and unanswered questions related to TAVI procedures in different groups of patients and highlighted opportunities and trends related to future TAVI implementation.
在过去的几年中，人们一直在努力开发和完善经皮心脏瓣膜修复和置换方法，其进展速度甚至超过了最乐观的预期。新的创新主要针对工业化世界最常见的瓣膜性心脏病（VHD）形式；主动脉瓣狭窄（AS）。迄今为止，已经完成了大约 250,000 例经导管主动脉瓣植入术（TAVI），以满足这一重大医疗需求。由于退行性病因占主导地位，VHD 在 65 岁以上人群中的患病率显著增加，尤其是严重的 AS。随着工业化国家的人口继续老龄化，对于治疗严重 AS 的创伤更小、更安全的方法的需求将继续增长。在这篇综述中，我们提供了 TAVI 在当前临床实践中的全面和最新概述。我们还解决了与不同患者群体的 TAVI 程序相关的困境和未解决的问题，并强调了与未来 TAVI 实施相关的机会和趋势。
