The Heart Hospital Baylor Plano, Baylor Scott & White Health, Plano, TX, USA.
Cleve Clin J Med. 2017 Dec;84(12 Suppl 4):e10-e14. doi: 10.3949/ccjm.84.s4.03.
Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population. Although emerging evidence supports its use in lower-risk patients, some adverse events may limit its adoption in a wider patient population. These include stroke, paravalvular leak, valve durability, valve thrombosis, and need for pacemaker replacement. Ongoing clinical trials are expected to provide answers.
经导管主动脉瓣置换术（TAVR）已逐渐取代有症状的重度主动脉瓣狭窄患者的外科主动脉瓣置换术（SAVR），主要针对手术并发症风险较高的患者。随着 TAVR 在技术进步和患者对微创手术偏好的推动下的应用增加，研究提供了支持 TAVR 疗效和安全性的数据。最近，TAVR 已扩展到中危患者，增加了潜在的患者群体。尽管新出现的证据支持将其用于低危患者，但一些不良事件可能会限制其在更广泛的患者群体中的应用。这些不良事件包括中风、瓣周漏、瓣膜耐久性、瓣膜血栓形成以及需要更换起搏器。正在进行的临床试验有望提供答案。
