Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium and Faculty of Medicine and Life Sciences Hasselt University.
Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 8, CH-3010 Bern, Switzerland.
Eur Heart J. 2017 Dec 1;38(45):3341-3350. doi: 10.1093/eurheartj/ehx390.
Transcatheter aortic valve implantation (TAVI) has emerged as a valuable treatment alternative to surgical aortic valve replacement among patients with symptomatic aortic stenosis at increased surgical risk. The rapid technological evolution from early to current-generation TAVI systems with low-profile delivery catheters, bioprosthetic valves with proven midterm durability, and improved positioning and retrieval features have made important contributions to the widespread clinical use of this minimal invasive therapy. Although peri-procedural and long-term thrombotic and bleeding events after TAVI remain a relevant concern, the optimal antithrombotic strategy and duration to mitigate these risks remain unclear. This review provides an overview of recent insights in this field, and highlights current and future antithrombotic trials focusing on optimizing outcomes in patients undergoing TAVI.
经导管主动脉瓣植入术(TAVI)已成为一种有价值的治疗选择,可用于手术风险增加的有症状主动脉瓣狭窄患者,替代外科主动脉瓣置换术。从早期到当前一代的 TAVI 系统的快速技术发展,具有低轮廓输送导管、中期耐久性得到证实的生物假体瓣膜以及改进的定位和取回功能,为这种微创治疗的广泛临床应用做出了重要贡献。尽管 TAVI 后的围手术期和长期血栓形成和出血事件仍然是一个相关的关注点,但减轻这些风险的最佳抗血栓策略和持续时间仍不清楚。这篇综述提供了该领域的最新见解概述,并强调了目前和未来的抗血栓试验,重点是优化接受 TAVI 的患者的结果。