Ielasi Alfonso, Latib Azeem, Tespili Maurizio, Donatelli Francesco
Clinical and Interventional Cardiology Unit, Sant'Ambrogio Cardio-Thoracic Center, Milan, Italy.
Department of Cardiology, Montefiore Medical Center, New York, NY, United States.
Int J Cardiol Heart Vasc. 2019 May 15;23:100375. doi: 10.1016/j.ijcha.2019.100375. eCollection 2019 Jun.
TAVR has become the standard treatment in patients at increased surgical risk (STS or EuroSCORE II ≥4% or logistic EuroSCORE ≥ 10% or other risk factors not included in these scores such as frailty, porcelain aorta, sequelae of chest radiation) and it is increasingly being performed in patients at intermediate to low (STS or EuroSCORE II <4% or logistic EuroSCORE < 10%) surgical risk. Although non-inferiority has been demonstrated in intermediate and low-risk patients, several challenges need to be addressed before expansion to younger patients. Current trends, trials results, and remaining challenges are summarized and discussed in this review.
经导管主动脉瓣置换术（TAVR）已成为手术风险增加患者（胸外科医师协会[STS]或欧洲心脏手术风险评估系统II[EuroSCORE II]≥4%或逻辑EuroSCORE≥10%或这些评分未包括的其他风险因素，如身体虚弱、瓷化主动脉、胸部放疗后遗症）的标准治疗方法，并且越来越多地应用于手术风险为中低水平（STS或EuroSCORE II<4%或逻辑EuroSCORE<10%）的患者。尽管已证明在中低风险患者中TAVR不劣于传统手术，但在将其扩展至年轻患者之前仍需应对一些挑战。本综述总结并讨论了当前的趋势、试验结果以及尚存的挑战。
