经导管主动脉瓣置换术：低危患者的当前实践和考虑因素综述。
TAVR: A Review of Current Practices and Considerations in Low-Risk Patients.
机构信息
Department of Medicine, Pennsylvania Hospital, University of Pennsylvania Health System (UPHS), Philadelphia, PA, USA.
Department of Cardiology, Pennsylvania Hospital, University of Pennsylvania Health System (UPHS), Philadelphia, PA, USA.
出版信息
J Interv Cardiol. 2020 Dec 24;2020:2582938. doi: 10.1155/2020/2582938. eCollection 2020.
Abstract
Transcatheter aortic valve replacement (TAVR) is an established treatment for severe, symptomatic, aortic stenosis (AS) in patients of all risk categories and now comprises 12.5% of all aortic valve replacements. TAVR is a less invasive alternative to traditional surgical aortic valve replacement (SAVR), with equivalent or superior outcomes. The use of TAVR has increased rapidly. The success and increase in use of TAVR are a result of advances in technology, greater operator experience, and improved outcomes. Indications have recently expanded to include patients considered to be at low risk for SAVR. While TAVR outcomes have improved, remaining challenges include the management of coexistent coronary artery disease, prevention of periprocedural stroke, and issue of durability. These issues are even more relevant for low-risk, younger patients.
摘要
经导管主动脉瓣置换术（TAVR）是一种成熟的治疗方法，适用于所有风险类别的严重、有症状的主动脉瓣狭窄（AS）患者，目前占所有主动脉瓣置换术的 12.5%。TAVR 是一种较传统的外科主动脉瓣置换术（SAVR）更为微创的替代方法，具有同等或更好的效果。TAVR 的应用迅速增加。TAVR 的成功和应用的增加是技术进步、更多的操作人员经验和更好的结果的结果。适应证最近已扩大到包括被认为低危的 SAVR 患者。虽然 TAVR 的结果已经改善，但仍然存在一些挑战，包括并存的冠状动脉疾病的管理、预防围手术期中风以及耐久性问题。这些问题对于低危、年轻的患者更为重要。
相似文献
1
TAVR: A Review of Current Practices and Considerations in Low-Risk Patients.经导管主动脉瓣置换术：低危患者的当前实践和考虑因素综述。
J Interv Cardiol. 2020 Dec 24;2020:2582938. doi: 10.1155/2020/2582938. eCollection 2020.
2
Rationale and design of a prospective, randomized, controlled, multicenter study to evaluate the safety and efficacy of transcatheter heart valve replacement in female patients with severe symptomatic aortic stenosis requiring aortic valve intervention (Randomized researcH in womEn all comers wIth Aortic stenosis [RHEIA] trial).背景与设计：一项前瞻性、随机、对照、多中心研究，旨在评估经导管主动脉瓣置换术在需要主动脉瓣干预的严重症状性主动脉瓣狭窄女性患者中的安全性和疗效（随机研究在所有适合接受主动脉瓣狭窄介入治疗的女性患者中[RHEIA 试验]）。
Am Heart J. 2020 Oct;228:27-35. doi: 10.1016/j.ahj.2020.06.016. Epub 2020 Jun 30.
3
The risk and extent of neurologic events are equivalent for high-risk patients treated with transcatheter or surgical aortic valve replacement.接受经导管或外科主动脉瓣置换术治疗的高危患者发生神经事件的风险和程度相当。
J Thorac Cardiovasc Surg. 2016 Jul;152(1):85-96. doi: 10.1016/j.jtcvs.2016.02.073. Epub 2016 Mar 12.
4
Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses.经导管主动脉瓣置换术（TAVR）中应用 CoreValve 人工瓣膜与外科手术中应用猪或牛生物瓣膜治疗主动脉瓣狭窄患者的左心室重构差异。
Eur Heart J Cardiovasc Imaging. 2018 Jan 1;19(1):39-46. doi: 10.1093/ehjci/jew321.
5
Expanding indications for TAVR: The preferred procedure in intermediate-risk patients?经导管主动脉瓣置换术（TAVR）适应证的扩展：中危患者的首选治疗方案？
Cleve Clin J Med. 2017 Dec;84(12 Suppl 4):e10-e14. doi: 10.3949/ccjm.84.s4.03.
6
Outcomes of intermediate-risk patients treated with transcatheter and surgical aortic valve replacement in the Veterans Affairs Healthcare System: A single center 20-year experience.退伍军人事务医疗系统中接受经导管和外科主动脉瓣置换术治疗的中度风险患者的结局：单中心20年经验
Catheter Cardiovasc Interv. 2018 Aug 1;92(2):390-398. doi: 10.1002/ccd.27478. Epub 2018 Jan 9.
7
Ten-year experience with transcatheter and surgical aortic valve replacement in Finland.芬兰经导管主动脉瓣置换术和外科主动脉瓣置换术的 10 年经验。
Ann Med. 2019 May-Jun;51(3-4):270-279. doi: 10.1080/07853890.2019.1614657. Epub 2019 May 21.
8
Comparison of Outcomes After Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement Among Patients With Aortic Stenosis at Low Operative Risk.经导管主动脉瓣置换术与外科主动脉瓣置换术治疗低手术风险主动脉瓣狭窄患者的结局比较。
JAMA Netw Open. 2019 Jun 5;2(6):e195742. doi: 10.1001/jamanetworkopen.2019.5742.
9
The impact of mitral stenosis on outcomes of aortic valve stenosis patient undergoing surgical aortic valve replacement or transcatheter aortic valve replacement.二尖瓣狭窄对接受外科主动脉瓣置换术或经导管主动脉瓣置换术的主动脉瓣狭窄患者预后的影响。
J Interv Cardiol. 2018 Oct;31(5):655-660. doi: 10.1111/joic.12519. Epub 2018 May 17.
10
A Comparative Study of TAVR versus SAVR in Moderate and High-Risk Surgical Patients: Hospital Outcome and Midterm Results.中高危手术患者经导管主动脉瓣置换术与外科主动脉瓣置换术的比较研究：医院结局和中期结果
Heart Surg Forum. 2019 Aug 27;22(5):E331-E339. doi: 10.1532/hsf.2243.
引用本文的文献
1
Pharmacology in Structural Intervention for Valvular Heart Disease: Current Practice and Future Perspectives.心脏瓣膜病结构干预中的药理学：当前实践与未来展望
Struct Heart. 2024 Nov 22;9(7):100360. doi: 10.1016/j.shj.2024.100360. eCollection 2025 Jul.
2
Comparison of TAVR with SAVR on clinical outcomes in patients with aortic stenosis: a systematic review and meta-analysis.经导管主动脉瓣置换术（TAVR）与外科主动脉瓣置换术（SAVR）治疗主动脉瓣狭窄患者临床结局的比较：一项系统评价和荟萃分析
Ann Med Surg (Lond). 2025 May 21;87(6):3768-3776. doi: 10.1097/MS9.0000000000003275. eCollection 2025 Jun.
3
Early Changes in Left Ventricular Myocardial Mechanics After Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.重度主动脉瓣狭窄经导管主动脉瓣置换术后左心室心肌力学的早期变化
Circ Rep. 2025 Mar 27;7(5):365-371. doi: 10.1253/circrep.CR-24-0139. eCollection 2025 May 9.
4
[Structural valve deterioration after transcatheter aortic valve replacement: a research update].[经导管主动脉瓣置换术后结构性瓣膜退化：研究进展]
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2025 Mar 25;54(2):183-190. doi: 10.3724/zdxbyxb-2024-0470.
5
Outcomes of transcatheter vs surgical aortic valve replacement in pre-existing chronic liver disease patients: A meta-analysis of observational studies.经导管与外科主动脉瓣置换术在已患慢性肝病患者中的疗效：观察性研究的荟萃分析
Int J Cardiol Heart Vasc. 2025 Mar 28;58:101651. doi: 10.1016/j.ijcha.2025.101651. eCollection 2025 Jun.
6
Weekend effect on in-hospital outcomes of transcatheter aortic valve replacement: insights from a propensity-matched national analysis.经导管主动脉瓣置换术住院结局的周末效应：一项倾向评分匹配的全国性分析的见解
BMC Cardiovasc Disord. 2025 Jan 31;25(1):67. doi: 10.1186/s12872-025-04509-x.
7
Cost-effectiveness of TAVI in the United Kingdom: a long-term analysis based on 4-year data from the Evolut Low Risk Trial.经导管主动脉瓣植入术在英国的成本效益：基于Evolut低风险试验4年数据的长期分析
Eur J Health Econ. 2024 Nov 23. doi: 10.1007/s10198-024-01739-2.
8
Thrombogenic Risk Assessment of Transcatheter Prosthetic Heart Valves Using a Fluid-Structure Interaction Approach.基于流固耦合方法的经导管人工心脏瓣膜血栓形成风险评估
Comput Methods Programs Biomed. 2024 Dec;257:108469. doi: 10.1016/j.cmpb.2024.108469. Epub 2024 Oct 28.
9
Rest, replace, and recover: TandemHeart to transcatheter aortic valve replacement-a case report.休息、置换与恢复：经皮心肺支持系统联合经导管主动脉瓣置换术——病例报告
Eur Heart J Case Rep. 2024 Sep 2;8(9):ytae465. doi: 10.1093/ehjcr/ytae465. eCollection 2024 Sep.
10
Where are we getting it wrong? Prevalence and causes of unplanned SAVR in a UK regional cardiac centre.我们哪里出错了？英国某地区心脏中心非计划心脏瓣膜置换术的发生率及原因。
Br J Cardiol. 2023 Sep 5;30(3):26. doi: 10.5837/bjc.2023.026. eCollection 2023.
本文引用的文献
1
Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Variation in Practice and Outcomes.经导管主动脉瓣置换术中的清醒镇静与全身麻醉：实践与结局的差异。
JACC Cardiovasc Interv. 2020 Jun 8;13(11):1277-1287. doi: 10.1016/j.jcin.2020.03.008.
2
Current issues in transcatheter aortic valve replacement.经导管主动脉瓣置换术的当前问题
J Thorac Dis. 2020 Apr;12(4):1665-1680. doi: 10.21037/jtd.2020.01.10.
3
Trends in vascular complications and associated treatment strategies following transfemoral transcatheter aortic valve replacement.经股动脉经导管主动脉瓣置换术后血管并发症的趋势及相关治疗策略。
J Vasc Surg. 2020 Oct;72(4):1313-1324.e5. doi: 10.1016/j.jvs.2020.01.050. Epub 2020 Mar 10.
4
A favorable lifestyle lowers the risk of coronary artery disease consistently across strata of non-modifiable risk factors in a population-based cohort.在一个基于人群的队列中，有利的生活方式在不可改变的风险因素的各个层次上一致降低了冠心病的风险。
BMC Public Health. 2019 Nov 27;19(1):1575. doi: 10.1186/s12889-019-7948-x.
5
Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry.超声引导下血管入路部位管理及左心室起搏与当代经导管主动脉瓣置换术预后改善相关：来自牛津经导管主动脉瓣置换术（OxTAVI）注册研究的见解
Catheter Cardiovasc Interv. 2020 Aug;96(2):432-439. doi: 10.1002/ccd.28578. Epub 2019 Nov 19.
6
Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients.经导管主动脉瓣置换术与外科主动脉瓣置换术在低危患者中的比较。
J Am Coll Cardiol. 2019 Sep 24;74(12):1532-1540. doi: 10.1016/j.jacc.2019.06.076.
7
New-onset left bundle branch block after transcatheter aortic valve replacement is associated with adverse long-term clinical outcomes in intermediate-risk patients: an analysis from the PARTNER II trial.经导管主动脉瓣置换术后新发左束支传导阻滞与中危患者不良长期临床结局相关：来自 PARTNER II 试验的分析。
Eur Heart J. 2019 Jul 14;40(27):2218-2227. doi: 10.1093/eurheartj/ehz227.
8
Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis.经导管主动脉瓣植入术与外科主动脉瓣置换术治疗症状性重度主动脉瓣狭窄的比较：一项更新的荟萃分析。
Eur Heart J. 2019 Oct 7;40(38):3143-3153. doi: 10.1093/eurheartj/ehz275.
9
The Role of Multimodality Imaging in Transcatheter Aortic Valve Replacement.多模态影像学在经导管主动脉瓣置换术中的作用。
Curr Cardiol Rep. 2019 Jul 19;21(8):84. doi: 10.1007/s11886-019-1172-2.
10
Coronary Artery Disease and Transcatheter Aortic Valve Replacement: JACC State-of-the-Art Review.冠状动脉疾病与经导管主动脉瓣置换术：JACC 最新技术评论。
J Am Coll Cardiol. 2019 Jul 23;74(3):362-372. doi: 10.1016/j.jacc.2019.06.012.
Zotero 插件