Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Clinical and Molecular Medicine, School of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy.
Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Cardiovasc Revasc Med. 2022 Sep;42:161-170. doi: 10.1016/j.carrev.2022.03.006. Epub 2022 Mar 10.
Over the last two decades there has been a significant shift towards the use of bioprostheses in the context of surgical aortic valve replacement, despite the well-known process of structural valve deterioration (SVD). This process has been extensively evaluated even though with many different definitions and methods, thus, the true long-term durability of surgical bioprostheses is not yet fully elucidated. Following the increasing implementation of the transcatheter aortic valve implantation (TAVI) technology, a better understanding of the long-term durability of transcatheter bioprostheses has become increasingly important as well, despite the limited availability of such data compared to the surgical experience. This lack of knowledge is a major barrier to the use of TAVI platforms to treat relatively younger patients. We thus aimed at providing an overview on long-term actual data concerning the durability of bioprostheses focusing on definition, incidence, and subsequent management of SVD of both surgical and transcatheter bioprosthetic aortic valves.
在过去的二十年中,尽管存在众所周知的结构性瓣膜退化(SVD)问题,但在外科主动脉瓣置换手术中,生物假体的使用已经发生了重大转变。尽管有许多不同的定义和方法,但人们已经对这个过程进行了广泛的评估,因此,外科生物假体的真正长期耐久性尚未完全阐明。随着经导管主动脉瓣植入术(TAVI)技术的不断实施,人们越来越需要更好地了解经导管生物假体的长期耐久性,尽管与外科经验相比,这类数据的可获得性有限。这种知识的缺乏是将 TAVI 平台用于治疗相对年轻患者的主要障碍。因此,我们旨在提供关于生物假体耐久性的长期实际数据的概述,重点是外科和经导管生物瓣主动脉瓣的 SVD 的定义、发生率和后续管理。