Hon Jimmy Kim Fatt, Tay Edgar
National University Heart Centre, National University of Singapore, Singapore.
Ann Cardiothorac Surg. 2017 Sep;6(5):504-509. doi: 10.21037/acs.2017.08.05.
The use of transcatheter aortic valve implantation (TAVI) to treat severe symptomatic aortic valve stenosis has increased exponentially in the last decade. This rapid expansion was seen predominantly in Western developed nations and has been fuelled by favorable results reported from a plethora of well-publicized randomized controlled trials, large retrospective series and national registries. Now, TAVI has become the standard of care for inoperable patients and an alternative to open surgery in patients who are at intermediate to high risk for open surgery. Notwithstanding these positive results, Asia has been relatively slow to adopt this technology despite a potentially large patient pool. Unique features of Asian medical environments and differences in Asian anatomy affecting TAVI uptake in Asia will be discussed. This article serves to outline the various challenging aspects of disseminating TAVI in Asian countries.
在过去十年中，经导管主动脉瓣植入术（TAVI）用于治疗重度有症状主动脉瓣狭窄的情况呈指数级增长。这种快速扩张主要出现在西方发达国家，大量广为人知的随机对照试验、大型回顾性系列研究和国家登记处报告的良好结果推动了这一增长。如今，TAVI已成为无法手术患者的标准治疗方法，也是开放手术中高风险患者的替代选择。尽管取得了这些积极成果，但亚洲采用这项技术的速度相对较慢，尽管潜在患者群体庞大。将讨论亚洲医疗环境的独特特征以及影响亚洲TAVI应用的亚洲解剖结构差异。本文旨在概述在亚洲国家推广TAVI的各个具有挑战性的方面。
