O'Sullivan Crochan J, Wenaweser Peter
Department of Cardiology, Stadtspital Triemli, Zurich, Switzerland.
Department of Cardiology, University Hospital Bern, Inselspital, Switzerland.
Interv Cardiol. 2017 May;12(1):44-50. doi: 10.15420/icr.2016:24:2.
Transcatheter aortic valve implantation (TAVI) has evolved into a safe and effective procedure to treat symptomatic patients with severe aortic stenosis (AS), with predictable and reproducible results. Rates of important complications such as vascular complications, strokes and paravalvular leaks are lower than ever, because of improved patient selection, systematic use of multidector computer tomography, increasing operator experience and device iteration. Accumulating data suggest that transfemoral TAVI with newer generation transcatheter heart valves and delivery systems is superior to conventional surgical aortic valve replacement among intermediate- and high-risk patients with severe symptomatic AS with regard to all-cause mortality and stroke. One can anticipate that by 2020, the majority of patients with severe symptomatic AS will undergo TAVI as first line therapy, regardless of surgical risk.
经导管主动脉瓣植入术（TAVI）已发展成为一种安全有效的治疗有症状的严重主动脉瓣狭窄（AS）患者的方法，其结果具有可预测性和可重复性。由于患者选择的改善、多排计算机断层扫描的系统应用、术者经验的增加以及器械的迭代，血管并发症、中风和瓣周漏等重要并发症的发生率比以往任何时候都低。越来越多的数据表明，对于有严重症状的中高危AS患者，使用新一代经导管心脏瓣膜和输送系统进行经股动脉TAVI在全因死亡率和中风方面优于传统外科主动脉瓣置换术。可以预计，到2020年，大多数有严重症状的AS患者将接受TAVI作为一线治疗，而不论手术风险如何。
