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经导管主动脉瓣置换术:当前趋势与未来方向

Transcatheter Aortic Valve Replacements: Current Trends and Future Directions.

作者信息

Goeddel Lee A, Serini Jessica, Steyn Johannes W, Evans Adam S, Dwarakanath Sanjay, Ramakrishna Harish, Augoustides John, Brady Mary Beth

机构信息

1 Johns Hopkins School of Medicine, Baltimore, MD, USA.

2 University of Kentucky, Lexington, KY, USA.

出版信息

Semin Cardiothorac Vasc Anesth. 2019 Sep;23(3):282-292. doi: 10.1177/1089253218779389. Epub 2018 Jun 5.

Abstract

Since the 1960s when the first aortic surgical aortic valve replacement (SAVR) was performed, continuous growth in the field of valvular technology has occurred. Although SAVR remains a lifesaving procedure, minimally invasive transcatheter aortic valve replacement has revolutionized and expanded aortic valve replacement to patients who were not previously SAVR candidates, increasing their quality of life and survival. Since its introduction in the United States in 2011, the technology and practice have rapidly expanded. Hybrid techniques have been developed that combine surgical access to the vasculature with valvular deployment over transcatheter systems. This literature review aims to describe the differences between the current available valve technologies, review approaches to surgical technique, discuss anesthetic considerations, and look forward to future directions, trends, and challenges.

摘要

自20世纪60年代首次进行主动脉外科主动脉瓣置换术(SAVR)以来,瓣膜技术领域持续发展。尽管SAVR仍是一种挽救生命的手术,但微创经导管主动脉瓣置换术已经彻底改变并扩大了主动脉瓣置换术的适用范围,使其能够应用于以前不适合进行SAVR的患者,提高了他们的生活质量和生存率。自2011年该技术在美国引入以来,其技术和应用迅速扩展。已经开发出了混合技术,即将血管系统的手术入路与经导管系统上的瓣膜部署相结合。这篇文献综述旨在描述当前可用瓣膜技术之间的差异,回顾手术技术方法,讨论麻醉相关考虑因素,并展望未来的方向、趋势和挑战。

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