Koutsias Stylianos, Karaolanis Georgios I, Papafaklis Michail I, Peroulis Michail, Tzimas Petros, Lakkas Lampros, Mitsis Michail, Naka Katerina K, Michalis Lampros K
Vascular Unit, Department of Surgery, Medical School, University of Ioannina, Ioannina, Greece.
Second Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece.
Vasc Endovascular Surg. 2020 Aug;54(6):544-548. doi: 10.1177/1538574420927864. Epub 2020 May 27.
The prevalence of concomitant abdominal aortic aneurysm (AAA) and severe aortic stenosis (AS) has been increasing in the elderly population. Both conditions have adverse outcomes, if not adequately managed. No clear recommendations are available in the literature until today, in regards of the management sequence making thus the decision-making challenging. We report 2 cases of AAA and significant AS treated with endovascular aortic repair (EVAR) and transcatheter aortic valve implantation (TAVI) during the same procedure and a review of the literature on this topic. Based on our experience, the combined procedure with TAVI followed by EVAR seems to be feasible, safe, and effective while detailed preoperative planning and a carefully tailored management strategy by a multidisciplinary team are essential.
在老年人群中，腹主动脉瘤（AAA）与严重主动脉瓣狭窄（AS）并存的情况日益增多。若管理不当，这两种病症都会产生不良后果。直至今日，文献中尚无关于治疗顺序的明确建议，这使得决策颇具挑战性。我们报告了2例在同一手术过程中接受血管腔内主动脉修复术（EVAR）和经导管主动脉瓣植入术（TAVI）治疗的AAA合并严重AS病例，并对该主题的文献进行了综述。根据我们的经验，先进行TAVI再进行EVAR的联合手术似乎可行、安全且有效，而详细的术前规划以及多学科团队精心定制的管理策略至关重要。
