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经导管主动脉瓣植入术治疗二叶式主动脉瓣疾病:手术规划与临床结果

Transcatheter Aortic Valve Implantation for Bicuspid Aortic Valve Disease: Procedural Planning and Clinical Outcomes.

作者信息

Gutierrez Lola, Boiago Mauro, De Biase Chiara, Oliva Omar, Laforgia Pietro, Feliachi Souheib, Beneduce Alessandro, Dumonteil Nicolas, Tchetche Didier

机构信息

Groupe Cardiovasculaire Interventionnel (GCVI), Clinique Pasteur, 31300 Toulouse, France.

出版信息

J Clin Med. 2023 Nov 14;12(22):7074. doi: 10.3390/jcm12227074.


DOI:10.3390/jcm12227074
PMID:38002687
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10672483/
Abstract

Bicuspid aortic valve (BAV) is the most common congenital heart disease, with a prevalence of 1-2% and occurring in >20% of octogenarians referred for aortic valve replacement. However, BAV patients have been systematically excluded from pivotal randomized trials. Since TAVI indications are moving toward low-risk patients, an increase in the number of BAV patients who undergo TAVI is expected. BAV represents a challenge due to its unique morphological features (raphe, extreme asymmetrical valve calcifications, cusp asymmetry and aortopathy) and the lack of consensus about the accurate sizing method. The role of multi-slice computed tomography (MSCT) in the planification of the TAVI procedure is well-established, being useful to define the optimal valve sizing and the implantation strategy. New-generation devices, more experience of the operators and better planification of the procedure have been associated with similar clinical outcomes in bicuspid and tricuspid patients undergoing TAVI.

摘要

二叶式主动脉瓣(BAV)是最常见的先天性心脏病,患病率为1%-2%,在接受主动脉瓣置换术的80岁以上老人中,其发病率超过20%。然而,BAV患者已被系统性地排除在关键随机试验之外。由于经导管主动脉瓣植入术(TAVI)的适应症正朝着低风险患者发展,预计接受TAVI的BAV患者数量将会增加。BAV因其独特的形态特征(嵴、极度不对称的瓣膜钙化、瓣叶不对称和主动脉病变)以及缺乏关于准确尺寸测量方法的共识而构成挑战。多层计算机断层扫描(MSCT)在TAVI手术规划中的作用已得到充分确立,有助于确定最佳瓣膜尺寸和植入策略。新一代设备、操作者更丰富的经验以及更好的手术规划,已使接受TAVI的二叶式和三叶式患者获得了相似的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/fa880d7cbb21/jcm-12-07074-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/13758be84c05/jcm-12-07074-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/afcb38d033a9/jcm-12-07074-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/ed885dd06fae/jcm-12-07074-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/cfb3ad109e1f/jcm-12-07074-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/f7fcae5da311/jcm-12-07074-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/489de67d527e/jcm-12-07074-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/fa880d7cbb21/jcm-12-07074-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/13758be84c05/jcm-12-07074-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/afcb38d033a9/jcm-12-07074-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/ed885dd06fae/jcm-12-07074-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/cfb3ad109e1f/jcm-12-07074-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/f7fcae5da311/jcm-12-07074-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/489de67d527e/jcm-12-07074-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6137/10672483/fa880d7cbb21/jcm-12-07074-g007.jpg

相似文献

[1]
Transcatheter Aortic Valve Implantation for Bicuspid Aortic Valve Disease: Procedural Planning and Clinical Outcomes.

J Clin Med. 2023-11-14

[2]
Bicuspid aortic valve sizing for transcatheter aortic valve implantation: Development and validation of an algorithm based on multi-slice computed tomography.

J Cardiovasc Comput Tomogr. 2020-1-25

[3]
Bicuspid Valve Sizing for Transcatheter Aortic Valve Implantation: The Missing Link.

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[4]
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Front Cardiovasc Med. 2022-7-28

[5]
Comparison of patients with bicuspid and tricuspid aortic valve in transcatheter aortic valve implantation.

Expert Rev Med Devices. 2023-3

[6]
Bicuspid Aortic Valve Stenosis: From Pathophysiological Mechanism, Imaging Diagnosis, to Clinical Treatment Methods.

Front Cardiovasc Med. 2022-2-8

[7]
Aortic annulus sizing in stenotic bicommissural non-raphe-type bicuspid aortic valves: reconstructing a three-dimensional structure using only two hinge points.

Clin Res Cardiol. 2018-6-14

[8]
Aortic valve anatomy and outcomes after transcatheter aortic valve implantation in bicuspid aortic valves.

Int J Cardiol. 2018-9-1

[9]
Ten-year experience with transcatheter aortic valve implantation in bicuspid aortic valve: lessons learned and future perspectives.

Postepy Kardiol Interwencyjnej. 2021-9

[10]
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引用本文的文献

[1]
Transcatheter Aortic Valve Implantation (TAVI) in Bicuspid Anatomy.

J Clin Med. 2025-1-24

[2]
Who Lives Longer, the Valve or the Patient? The Dilemma of TAVI Durability and How to Optimize Patient Outcomes.

J Clin Med. 2024-10-14

本文引用的文献

[1]
Cusp overlap method for self-expanding transcatheter aortic valve replacement.

Catheter Cardiovasc Interv. 2024-1

[2]
Transcatheter aortic valve implantation with the Evolut platform for bicuspid aortic valve stenosis: the international, multicentre, prospective BIVOLUTX registry.

EuroIntervention. 2023-8-21

[3]
Application of Balloon-Expandable Transcatheter Heart Valve in Bicuspid Aortic Valve.

JACC Asia. 2021-9-21

[4]
Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement.

N Engl J Med. 2022-10-6

[5]
Transcatheter aortic valve implantation in patients with bicuspid valve morphology: a roadmap towards standardization.

Nat Rev Cardiol. 2023-1

[6]
2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).

Rev Esp Cardiol (Engl Ed). 2022-6

[7]
Update on supra-annular sizing of transcatheter aortic valve prostheses in raphe-type bicuspid aortic valve disease according to the LIRA method.

Eur Heart J Suppl. 2022-5-18

[8]
The PARTNER 3 Bicuspid Registry for Transcatheter Aortic Valve Replacement in Low-Surgical-Risk Patients.

JACC Cardiovasc Interv. 2022-3-14

[9]
Propensity-Matched 1-Year Outcomes Following Transcatheter Aortic Valve Replacement in Low-Risk Bicuspid and Tricuspid Patients.

JACC Cardiovasc Interv. 2022-3-14

[10]
Outcomes After Transcatheter Aortic Valve Replacement in Bicuspid Versus Tricuspid Anatomy: A Systematic Review and Meta-Analysis.

JACC Cardiovasc Interv. 2021-10-11

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