Yalta Kenan, Zorkun Cafer, Yilmaztepe Mustafa, Gurlertop Yekta
Trakya University, Cardiology Department, Edirne, Turkey.
Trakya University, Cardiology Department, Edirne, Turkey.
Indian Heart J. 2018 Nov-Dec;70(6):901-906. doi: 10.1016/j.ihj.2018.06.015. Epub 2018 Jun 23.
In the past years, transcatheter aortic valve implantation (TAVI) has emerged as a promising option for the treatment of aortic valve pathologies particularly in the the presence of surgically high-risk situations. Importantly, a variety of specific procedural complications including acute coronary osteal occlusion, though very rare, has been reported in major clinical studies. However, little is known about the late impact of TAVI on coronary system at the macro and microvascular levels. On the other hand, clinical studies as well as real life experiences have shown variable rates of acute coronary syndrome (ACS) readmissions among TAVI recipients in the short and long terms. Within this context, it may be suggested that even though late coronary ischemic events arising after TAVI, to some extent, appears to be spontaneous or attributable to certain stressors, TAVI may also have the potential to directly account for, accelerate or contribute to the evolution of these ischemic events on follow-up. Accordingly, the present review primarily focuses on potential association of TAVI with late coronary ischemic syndromes along with a particular emphasis on its mechanistic basis and clinical implications among TAVI recipients.
在过去几年中，经导管主动脉瓣植入术（TAVI）已成为治疗主动脉瓣病变的一种有前景的选择，尤其是在手术风险高的情况下。重要的是，在主要临床研究中已报告了包括急性冠状动脉骨化闭塞在内的多种特定手术并发症，尽管非常罕见。然而，关于TAVI对冠状动脉系统在宏观和微血管水平的晚期影响知之甚少。另一方面，临床研究以及实际经验表明，TAVI接受者在短期和长期内急性冠状动脉综合征（ACS）再入院率各不相同。在此背景下，可能有人认为，尽管TAVI术后出现的晚期冠状动脉缺血事件在某种程度上似乎是自发的或归因于某些应激源，但TAVI在随访中也可能直接导致、加速或促成这些缺血事件的发展。因此，本综述主要关注TAVI与晚期冠状动脉缺血综合征的潜在关联，特别强调其机制基础及在TAVI接受者中的临床意义。
