Chamandi Chekrallah, Puri Rishi, Rodriguez-Gabella Tania, Rodés-Cabau Josep
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Can J Cardiol. 2017 Sep;33(9):1082-1090. doi: 10.1016/j.cjca.2017.03.012. Epub 2017 Mar 25.
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks. This article reviews the main characteristics of, and clinical results associated with, the newer-generation THVs while providing an overview of novel TAVR indications.
经导管主动脉瓣置换术(TAVR)是一种成熟的治疗方法,适用于具有严重症状性主动脉瓣狭窄且手术风险高或手术禁忌的患者。最近,TAVR已成为治疗中度风险患者的有效替代手术主动脉瓣置换术的方法,目前有多项研究正在评估TAVR在低风险患者中的作用。随着时间的推移,经导管心脏瓣膜(THV)技术有了很大的发展,许多最新一代设备都进行了重要的改进,以(1)减小尺寸并改善输送系统性能;(2)改善瓣膜展开、重新定位和可回收性;(3)减少瓣周漏。本文回顾了新一代THV的主要特点和相关临床结果,同时概述了TAVR的新适应症。