Sharma Munish, Mascarenhas Daniel A N
Department of Internal Medicine, Easton Hospital , Easton, PA.
Drexel University College of Medicine , Philadelphia, PA; and Interventional Cardiologist, Easton Hospital, Easton, PA, USA.
Clin Pract. 2016 Nov 24;6(4):887. doi: 10.4081/cp.2016.887. eCollection 2016 Oct 24.
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR. Concomitant pathology leading to the symptoms should be carefully ruled out. This leads to a less invasive, cost effective care plan especially in patients with advanced age and comorbidities for which any type of surgical valvular intervention may pose high risk.
主动脉瓣置换术（AVR）仍然是有症状的严重主动脉瓣狭窄（AS）治疗的基石。对于有症状的严重AS患者，进行外科或经导管主动脉瓣置换术（TAVR）是I类适应症。我们报告一例患有严重AS和新发心绞痛的患者，通过右冠状动脉的经皮冠状动脉介入治疗（PCI）成功治疗。医生应认识到，并非所有患有严重AS和心绞痛的患者都必然需要AVR。应仔细排除导致症状的合并病变。这会带来侵入性较小、成本效益高的护理计划，特别是对于高龄和患有合并症的患者，任何类型的外科瓣膜干预都可能带来高风险。
