Langer Nathaniel B, Hamid Nadira B, Nazif Tamim M, Khalique Omar K, Vahl Torsten P, White Jonathon, Terre Juan, Hastings Ramin, Leung Diana, Hahn Rebecca T, Leon Martin, Kodali Susheel, George Isaac
From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY.
Circ Cardiovasc Interv. 2017 Jan;10(1). doi: 10.1161/CIRCINTERVENTIONS.116.004735.
The experience with transcatheter aortic valve replacement is increasing worldwide; however, the incidence of potentially catastrophic cardiac or aortic complications has not decreased. In most cases, significant injuries to the aorta, aortic valve annulus, and left ventricle require open surgical repair. However, the transcatheter aortic valve replacement patient presents a unique challenge as many patients are at high or prohibitive surgical risk and, therefore, an open surgical procedure may not be feasible or appropriate. Consequently, prevention of these potentially catastrophic injuries is vital, and practitioners need to understand when open surgical repair is required and when alternative management strategies can be used. The goal of this article is to provide an overview of current management and prevention strategies for major complications involving the aorta, aortic valve annulus, and left ventricle.
经导管主动脉瓣置换术在全球范围内的应用经验日益丰富；然而，潜在灾难性心脏或主动脉并发症的发生率并未降低。在大多数情况下，主动脉、主动脉瓣环和左心室的严重损伤需要进行开胸手术修复。然而，经导管主动脉瓣置换术患者带来了独特的挑战，因为许多患者手术风险高或无法承受手术，因此开胸手术可能不可行或不合适。因此，预防这些潜在的灾难性损伤至关重要，从业者需要了解何时需要开胸手术修复以及何时可以采用替代管理策略。本文的目的是概述涉及主动脉、主动脉瓣环和左心室的主要并发症的当前管理和预防策略。
