Akodad Mariama, Lefèvre Thierry
Ramsay Générale de Santé, Institut Cardiovasculaire Paris Sud, Massy, France.
Centre Hospitalier Universitaire Arnaud de Villeneuve, Montpellier, France.
Front Cardiovasc Med. 2018 Jul 18;5:96. doi: 10.3389/fcvm.2018.00096. eCollection 2018.
Since its introduction in 2002, TAVI has evolved dramatically and is now standard of care for intermediate risk patients when the femoral approach can be implemented safely. The development of innovative transcatheter heart valves (THVs) and refinement of technical skills have contributed to the decrease in complication rates associated with TAVI. Increased experience, smaller sheaths, rigorous pre-procedural planning and improved vascular closing techniques have resulted in markedly lower rates of vascular complications. The next step is the simplification of the procedure, which should contribute to a further decrease in complications, and also reduce procedural time, hospital stay as well as staff workload and costs. Moving to conscious sedation, no predilatation, no temporary pace maker and use of the radial approach as the contralateral approach are all instrumental in achieving this ultimate refinement.
自2002年首次引入以来，经导管主动脉瓣植入术（TAVI）已发生了巨大演变，当能够安全实施股动脉入路时，TAVI现已成为中度风险患者的标准治疗方法。创新性经导管心脏瓣膜（THV）的开发和技术技能的完善，有助于降低与TAVI相关的并发症发生率。经验的增加、鞘管尺寸的减小、严格的术前规划以及改进的血管闭合技术，已使血管并发症的发生率显著降低。下一步是简化手术过程，这应有助于进一步降低并发症发生率，同时减少手术时间、住院时间以及工作人员的工作量和成本。采用清醒镇静、不进行预扩张、不使用临时起搏器以及将桡动脉入路用作对侧入路，均有助于实现这一最终的完善。
