Patel Kunal V, Omar Wally, Gonzalez Pedro Engel, Jessen Michael E, Huffman Lynn, Kumbhani Dharam J, Bavry Anthony A
Division of Cardiology, University of Texas Southwestern Medical Center, Texas, USA.
Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Texas, USA.
Cardiol Ther. 2020 Dec;9(2):377-394. doi: 10.1007/s40119-020-00198-z. Epub 2020 Sep 1.
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis (AS) over the last decade. The results of the Placement of Aortic Transcatheter Valves (PARTNER) 3 and Evolut Low Risk trials demonstrated the safety and efficacy of TAVR in low-surgical-risk patients and led to the approval of TAVR for use across the risk spectrum. Heart teams around the world will now be faced with evaluating a deluge of younger, healthier patients with severe AS. Prior to the PARTNER 3 and Evolut Low Risk studies, this heterogenous patient population would have undergone surgical aortic valve replacement (SAVR). It is unlikely that TAVR will completely supplant SAVR for the treatment of severe AS in patients with a low surgical risk, as SAVR has excellent short- and long-term outcomes and years of durability data. In this review, we outline the critical role that SAVR will continue to play in the treatment of severe AS in the post-PARTNER 3/Evolut Low Risk era.
在过去十年中，经导管主动脉瓣置换术（TAVR）彻底改变了严重主动脉瓣狭窄（AS）的治疗方式。主动脉经导管瓣膜置入（PARTNER）3试验和Evolut低风险试验的结果证明了TAVR在低手术风险患者中的安全性和有效性，并促使TAVR被批准用于各种风险范围的患者。现在，世界各地的心脏团队将面临评估大量患有严重AS的年轻、健康患者的情况。在PARTNER 3和Evolut低风险研究之前，这类异质性患者群体原本会接受外科主动脉瓣置换术（SAVR）。TAVR不太可能完全取代SAVR用于治疗低手术风险的严重AS患者，因为SAVR具有出色的短期和长期疗效以及多年的耐久性数据。在本综述中，我们概述了SAVR在PARTNER 3/Evolut低风险时代之后治疗严重AS方面将继续发挥的关键作用。
