Hecker Florian, Arsalan Mani, Kim Won-Keun, Walther Thomas
Department of Cardiac Surgery, Kerckhoff Heartcenter, Bad Nauheim, Germany.
Department of Cardiology, Kerckhoff Heartcenter, Bad Nauheim, Germany.
Minerva Cardioangiol. 2018 Jun;66(3):314-328. doi: 10.23736/S0026-4725.17.04532-7. Epub 2017 Oct 25.
Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis (AS) who are at high or prohibitive surgical risk. In the past years, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement (SAVR) in the treatment of intermediate risk patients. Besides optimized patient screening, advanced imaging and increased examiner experience, transcatheter heart valve (THV) design addressed several key issues like vascular complications, pacemaker implantation and paravalvular leakage rates and improved considerably over time. Currently, several trials are investigating the role of TAVI in low surgical risk patients, novel indications and peri-operative management. In this review we give an overview on 1) current generation TAVI devices; on 2) recent clinical trial results and guidelines; and on 3) future trends and novel developments in the field of interventional treatment of AS.
经导管主动脉瓣植入术（TAVI）已成为有严重症状性主动脉瓣狭窄（AS）且手术风险高或禁忌的患者的一种安全且不可或缺的治疗选择。在过去几年中，TAVI术后的结果有了显著改善，并且在治疗中风险患者方面，TAVI已成为外科主动脉瓣置换术（SAVR）的合格替代方案。除了优化患者筛查、先进成像技术以及增加检查者经验外，经导管心脏瓣膜（THV）设计解决了诸如血管并发症、起搏器植入和瓣周漏发生率等几个关键问题，并且随着时间的推移有了相当大的改进。目前，多项试验正在研究TAVI在低手术风险患者中的作用、新适应症以及围手术期管理。在本综述中，我们概述了：1）当代TAVI设备；2）近期临床试验结果和指南；以及3）AS介入治疗领域的未来趋势和新进展。
