University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States.
Kardiol Pol. 2023;81(2):107-114. doi: 10.33963/KP.a2023.0026. Epub 2023 Jan 27.
With broadening applications of transcatheter aortic valve replacement (TAVR) and increasing use in intermediate- and low-risk patients, the incidence of surgical re-interventions after TAVR is growing. Transcatheter heart valves suffer from similar long-term complications as surgical heart valve prostheses that require surgical re-intervention, including endocarditis and structural valve deterioration. Catastrophic periprocedural complications - such as annular or aortic rupture requiring urgent surgical intervention - may also occur during TAVR procedures. This review summarizes the current knowledge on indications, methods, and outcomes of cardiac operations after TAVR, with a focus on how to improve results in a rapidly growing patient population.
随着经导管主动脉瓣置换术(TAVR)的应用范围不断扩大,以及在中低危患者中的应用不断增加,TAVR 后的手术再次干预的发生率也在不断增加。经导管心脏瓣膜与需要手术再次干预的外科心脏瓣膜假体一样,会出现类似的长期并发症,包括心内膜炎和结构性瓣膜恶化。在 TAVR 过程中,也可能发生灾难性的围手术期并发症,如需要紧急手术干预的瓣环或主动脉破裂。本综述总结了 TAVR 后心脏手术的适应证、方法和结果的现有知识,重点介绍了如何在快速增长的患者群体中改善结果。