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经导管主动脉瓣置换术(TAVR)中瓣中瓣手术的临床考量与挑战

Clinical considerations and challenges in TAV-in-TAV procedures.

作者信息

Hayek Ahmad, Prieur Cyril, Dürrleman Nicolas, Chatelain Quentin, Ibrahim Reda, Asgar Anita, Modine Thomas, Ben Ali Walid

机构信息

Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada.

Department of Interventional Cardiology, Hospices Civils de Lyon, Lyon, France.

出版信息

Front Cardiovasc Med. 2024 Feb 19;11:1334871. doi: 10.3389/fcvm.2024.1334871. eCollection 2024.

Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as a viable treatment for aortic valve disease, including low-risk patients. However, as TAVR usage increases, concerns about long-term durability and the potential for addition interventions have arisen. Transcatheter aortic valve (TAV)-in-TAV procedures have shown promise in selected patients in numerous registries, offering a less morbid alternative to TAVR explantation. In this review, the authors aimed to comprehensively review the experience surrounding TAV-in-TAV, summarize available data, discuss pre-procedural planning, highlight associated challenges, emphasize the importance of coronary obstruction assessment and provide insights into the future of this technique.

摘要

经导管主动脉瓣置换术(TAVR)已成为治疗主动脉瓣疾病的一种可行方法,包括低风险患者。然而,随着TAVR使用的增加,人们对其长期耐久性以及额外干预的可能性产生了担忧。在众多注册研究中,经导管主动脉瓣(TAV)置入TAV手术在特定患者中显示出前景,为TAVR取出术提供了一种并发症较少的替代方案。在本综述中,作者旨在全面回顾围绕TAV置入TAV的经验,总结现有数据,讨论术前规划,突出相关挑战,强调冠状动脉阻塞评估的重要性,并对该技术的未来提供见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e60/10910030/4c0ca5d6e0e4/fcvm-11-1334871-g001.jpg

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