Department of Cardiology, Barts Heart Center, Barts Health NHS Trust, London, United Kingdom.
EuroIntervention. 2019 Apr 5;14(18):e1826-e1833. doi: 10.4244/EIJ-D-18-01048.
Transcatheter aortic valve implantation (TAVI) has rapidly evolved and changed the landscape of structural interventional cardiology. Advances in transcatheter heart valve (THV) prostheses and TAVI-enabling devices have simplified the procedure, reduced the risk of complications, improved short- and long-term outcomes and broadened the applications of TAVI, not only in challenging patients and complex anatomies but also in intermediate-risk or even in low-risk patients, where surgical valve replacement constitutes an effective and well-established therapy. In this review article, we provide an overview of the developments in TAVI devices which have played a vital role in TAVI evolution: we describe the prostheses that failed to reach clinical practice, we present the characteristics of the first valves that were tested in the clinical arena, we summarise the evidence from the first studies that highlighted the potential but also the limitations of TAVI, and we present the advanced next-generation THV prostheses that have an improved performance and safety profile.
经导管主动脉瓣植入术（TAVI）迅速发展，改变了结构性介入心脏病学的格局。经导管心脏瓣膜（THV）假体和 TAVI 使能装置的进步简化了手术程序，降低了并发症风险，改善了短期和长期结果，并拓宽了 TAVI 的应用范围，不仅在具有挑战性的患者和复杂解剖结构中，而且在中危甚至低危患者中，外科瓣膜置换术都是一种有效且成熟的治疗方法。在这篇综述文章中，我们概述了在 TAVI 发展中发挥重要作用的 TAVI 装置的进展：我们描述了未能进入临床实践的假体，介绍了首次在临床领域进行测试的瓣膜的特点，总结了首次强调 TAVI 潜在优势和局限性的研究证据，并介绍了具有改进性能和安全性的先进的下一代 THV 假体。
