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经导管主动脉瓣置换术——现状与未来展望：“个性化治疗方法”

Transcatheter aortic valve replacement-state of the art and a glimpse to the future: 'the Tailored Approach'.

作者信息

Bedogni Francesco, Frigiola Alessandro, Ranucci Marco, Brambilla Nedy, Montone Rocco Antonio, Agnifili Mauro, Menicanti Lorenzo, Testa Luca

机构信息

Coronary Revascularisation Unit, IRCCS Policlinico S. Donato, S. Donato Milanese, piazza E. Malan, Milan, Italy.

出版信息

Eur Heart J Suppl. 2016 Apr 28;18(Suppl E):E86-E95. doi: 10.1093/eurheartj/suw017. Epub 2016 Apr 29.

DOI:10.1093/eurheartj/suw017
PMID:28533722
Abstract

Transcatheter aortic valve replacement determined a paradigm shift in the treatment of high-risk patients with severe symptomatic aortic valve stenosis. Notwithstanding the impressive results of the first-generation prostheses, a fast-paced technological evolution is taking place to overcome their limitations, in particular the vascular access damage and the paravalvular leak. Nowadays, with the availability of several different devices, the expert operator can select the right prosthesis for the specific anatomical and clinical situation. As 'One does not fit all', the 'Tailored TAVR Approach' we describe will conceivably become the future of this therapy.

摘要

经导管主动脉瓣置换术在高危重症症状性主动脉瓣狭窄患者的治疗中引发了范式转变。尽管第一代人工瓣膜取得了令人瞩目的成果，但为克服其局限性，尤其是血管通路损伤和瓣周漏，一场快节奏的技术变革正在发生。如今，有多种不同的器械可供使用，经验丰富的操作人员能够针对特定的解剖和临床情况选择合适的人工瓣膜。由于“一种方案并不适用于所有人”，我们所描述的“定制经导管主动脉瓣置换术方法”有望成为这种治疗方法的未来发展方向。

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引用本文的文献

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Evolution of outcome and complications in TAVR: a meta-analysis of observational and randomized studies.经导管主动脉瓣置换术（TAVR）结局和并发症的演变：观察性和随机研究的荟萃分析。
Sci Rep. 2020 Sep 23;10(1):15568. doi: 10.1038/s41598-020-72453-1.

本文引用的文献

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First registry results from the newly approved ACURATE TA™ TAVI system†.新获批的ACURATE TA™经导管主动脉瓣植入系统†的首批注册结果。
Eur J Cardiothorac Surg. 2015 Jul;48(1):137-41. doi: 10.1093/ejcts/ezu367. Epub 2014 Nov 25.
2
Stroke after transcatheter aortic valve replacement: incidence, risk factors, prognosis, and preventive strategies.经导管主动脉瓣置换术后的卒中：发生率、危险因素、预后及预防策略。
Clin Cardiol. 2014 Dec;37(12):756-64. doi: 10.1002/clc.22328. Epub 2014 Nov 17.
3
CoreValve implantation for severe aortic regurgitation: a multicentre registry.
经导管主动脉瓣植入术治疗重度主动脉瓣反流：多中心注册研究。
EuroIntervention. 2014 Oct;10(6):739-45. doi: 10.4244/EIJV10I6A127.
4
Transcatheter aortic valve replacement for severe symptomatic aortic stenosis using a repositionable valve system: 30-day primary endpoint results from the REPRISE II study.经导管主动脉瓣置换术治疗严重症状性主动脉瓣狭窄的可重定位瓣膜系统：REPRISE II 研究的 30 天主要终点结果。
J Am Coll Cardiol. 2014 Sep 30;64(13):1339-48. doi: 10.1016/j.jacc.2014.05.067.
5
Transcatheter aortic valve implantation in failed bioprosthetic surgical valves.经导管主动脉瓣植入术治疗失败的生物瓣。
JAMA. 2014 Jul;312(2):162-70. doi: 10.1001/jama.2014.7246.
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[Results of the OBSERVANT study: clinical characteristics and short-term outcome of the enrolled population treated with transcatheter versus surgical aortic valve implantation].[OBSERVANT研究结果：经导管与外科主动脉瓣植入治疗的入选人群的临床特征及短期结局]
G Ital Cardiol (Rome). 2014 Mar;15(3):177-84. doi: 10.1714/1463.16169.
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Treatment of aortic stenosis with a self-expanding transcatheter valve: the International Multi-centre ADVANCE Study.经导管自膨式主动脉瓣置换术治疗主动脉瓣狭窄：国际多中心 ADVANCE 研究。
Eur Heart J. 2014 Oct 7;35(38):2672-84. doi: 10.1093/eurheartj/ehu162. Epub 2014 Mar 28.
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N Engl J Med. 2014 May 8;370(19):1790-8. doi: 10.1056/NEJMoa1400590. Epub 2014 Mar 29.
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