Zhang Xiling, Puehler Thomas, Frank Derk, Sathananthan Janarthanan, Sellers Stephanie, Meier David, Both Marcus, Blanke Philipp, Seoudy Hatim, Saad Mohammed, Müller Oliver J, Sondergaard Lars, Lutter Georg
Department of Cardiovascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 24105 Kiel, Germany.
J Cardiovasc Dev Dis. 2022 Jul 12;9(7):223. doi: 10.3390/jcdd9070223.
In spite of the noninferiority of transcatheter aortic valve replacement (TAVR) in high- and intermediate-risk patients, there are still obstacles that need to be overcome before the procedure is further expanded and clinically integrated. The lack of evidence on the long-term durability of the bioprostheses used for TAVR remains of particular concern. In addition, surgery may be preferred over TAVR in patients with bicuspid aortic valve (BAV) or with concomitant pathologies such as other valve diseases (mitral regurgitation/tricuspid regurgitation), aortopathy, and coronary artery disease. In this review, we discuss and summarize relevant data from clinical trials, current trends, and remaining obstacles, and provide our perspective on the indications for the expansion of TAVR.
尽管经导管主动脉瓣置换术（TAVR）在高危和中危患者中具有非劣效性，但在该手术进一步扩大应用范围并实现临床整合之前，仍有一些障碍需要克服。用于TAVR的生物假体长期耐久性缺乏证据尤其令人担忧。此外，对于患有二叶式主动脉瓣（BAV）或伴有其他瓣膜疾病（二尖瓣反流/三尖瓣反流）、主动脉病变和冠状动脉疾病等伴随病变的患者，手术可能比TAVR更受青睐。在本综述中，我们讨论并总结了来自临床试验的相关数据、当前趋势和尚存的障碍，并就TAVR扩大应用的适应症提出我们的观点。
