Structural Cardiology Unit, Division of Cardiology, Department of Medical Specialties at the University Hospital of Geneva, Switzerland.
Structural Cardiology Unit, Division of Cardiology, Department of Medical Specialties at the University Hospital of Geneva, Switzerland.
Eur J Intern Med. 2018 Sep;55:12-19. doi: 10.1016/j.ejim.2018.07.002. Epub 2018 Jul 4.
During the last 15 years, transcatheter aortic valve implantation (TAVI) has gained wide acceptance with good reproducible clinical and safety outcomes. Today, TAVI has not only overtaken conventional surgery as the standard of care for the treatment of patients with symptomatic aortic stenosis at high surgical risk, but can also be considered in selected intermediate-risk patients. This follows technological improvements, better patient assessment and increased operator experience leading to a significant reduction in most procedure-related complications and long-term mortality. In this review, we provide internists, on the one hand with current data in the TAVI field including clinical outcomes from the most recent, major trials and on the other hand, highlight the remaining pitfalls of this treatment and the gaps in evidence that need to be addressed in order to further improve clinical practice and expand its indication.
在过去的 15 年中，经导管主动脉瓣植入术（TAVI）在具有良好可重复性的临床和安全性结果的基础上得到了广泛认可。如今，TAVI 不仅已经取代了传统手术，成为治疗高危外科手术风险的有症状主动脉瓣狭窄患者的标准治疗方法，而且还可以考虑用于选择的中危风险患者。这是由于技术改进、更好的患者评估和操作人员经验增加，导致大多数与手术相关的并发症和长期死亡率显著降低。在这篇综述中，我们为内科医生提供了 TAVI 领域的最新数据，包括来自最近的主要试验的临床结果，另一方面，还强调了这种治疗方法存在的遗留问题以及需要解决的证据空白，以进一步改善临床实践并扩大其适应证。
