van Wiechen Maarten P, Van Mieghem Nicolas M
Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Future Cardiol. 2019 Jan;15(1):1-8. doi: 10.2217/fca-2018-0064. Epub 2018 Dec 19.
The only curative treatment of aortic stenosis is through surgical or transcatheter aortic valve replacement. Transcatheter aortic valve implantation has evolved from its first in human experience in 2002 and matured to the treatment of first choice of symptomatic severe aortic stenosis in elderly patients with an elevated operative risk. The self-expanding CoreValve bioprosthesis has been on the forefront of this growing transcatheter aortic valve implantation experience. Over the last decade, various device iterations resulted in the current Evolut PRO self-expanding valve platform with reduced profile, repositioning/retrievable features and porcine pericardial wrap. Herein we provide a critical appraisal of the consecutive device iterations and highlight the clinical foundation for the use of the self-expanding CoreValve /Evolut platforms in current clinical practice.
主动脉瓣狭窄的唯一治愈性治疗方法是通过外科手术或经导管主动脉瓣置换术。经导管主动脉瓣植入术自2002年首次应用于人体以来不断发展,已成熟成为手术风险较高的老年有症状重度主动脉瓣狭窄患者的首选治疗方法。自膨胀式CoreValve生物瓣膜一直处于这种不断发展的经导管主动脉瓣植入经验的前沿。在过去十年中,各种器械迭代产生了当前的Evolut PRO自膨胀瓣膜平台,其具有更小的外形、可重新定位/可回收功能以及猪心包包裹。在此,我们对连续的器械迭代进行批判性评估,并强调在当前临床实践中使用自膨胀式CoreValve/Evolut平台的临床基础。