Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
Division of Cardiology, Department of Medicine, West Virginia University, Morgantown, WV.
J Cardiothorac Vasc Anesth. 2019 Oct;33(10):2853-2860. doi: 10.1053/j.jvca.2018.10.025. Epub 2018 Oct 23.
Aortic valve disease is a common condition whose prevalence is increasing, especially in Western countries. Two main families of cardiac prostheses are available: mechanical and biological prostheses. Nevertheless, the use of mechanical surgical valves has declined significantly over time in favor of bioprosthetic surgical valves even among middle-aged patients. The dominance of bioprosthetic valves was enhanced further with the introduction of transcatheter aortic valves. However, some concerns have arisen in recent years about clinical and subclinical leaflet thrombosis of both surgical and transcatheter bioprostheses. This manuscript aims to discuss the current evidence relating to the incidence, pathophysiology, clinical implications, and management strategies of biological valve leaflet thrombosis.
主动脉瓣疾病是一种常见病症,其患病率在不断增加,尤其是在西方国家。目前有两种主要类型的心脏假体:机械假体和生物假体。然而,随着时间的推移,机械心脏瓣膜的使用显著减少,生物心脏瓣膜甚至在中年患者中也更受欢迎。经导管主动脉瓣的引入进一步增强了生物瓣膜的主导地位。然而,近年来人们对生物瓣叶的临床和亚临床血栓形成的关注有所增加,包括外科生物瓣和经导管生物瓣。本文旨在讨论与生物瓣叶血栓形成的发生率、病理生理学、临床意义和管理策略相关的当前证据。