Naqvi Tasneem Z
Echocardiographic Laboratory, Department of Cardiology, Mayo Clinic, Scottsdale, AZ, USA.
Division of Cardiology, University of Southern California, Los Angeles, CA, USA.
Echocardiography. 2018 Jul;35(7):1005-1019. doi: 10.1111/echo.13799. Epub 2018 Feb 1.
Transcatheter aortic valve replacement (TAVR) has been a revolutionary technique in the treatment of degenerative aortic valve stenosis. Selection of appropriate patients and appropriate valve size is crucial for improved patient outcome. Echocardiographic imaging is a critical component for patient selection and plays an important role in the selection of valve size, procedural guidance, and patient follow-up. This review discusses role of echocardiography in patient selection, device implantation, and postimplant follow-up for the first-generation CoreValve as used in pivotal trial. Same TTE imaging principles apply to the second- and third-generation self-expandable valves as well as the balloon-expandable valves. Multiple case examples are used to illustrate imaging principles pre- and post-TAVR. In addition, case examples to demonstrate complications post-TAVR are shown.
经导管主动脉瓣置换术(TAVR)是治疗退行性主动脉瓣狭窄的一项革命性技术。选择合适的患者和合适的瓣膜尺寸对于改善患者预后至关重要。超声心动图成像对于患者选择至关重要,并且在瓣膜尺寸选择、手术指导和患者随访中发挥着重要作用。本综述讨论了超声心动图在关键试验中使用的第一代CoreValve的患者选择、装置植入和植入后随访中的作用。相同的经胸超声心动图(TTE)成像原理适用于第二代和第三代自膨胀瓣膜以及球囊扩张瓣膜。使用多个病例示例来说明TAVR前后的成像原理。此外,还展示了证明TAVR后并发症的病例示例。