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本文引用的文献

1
Comparison of the New-Generation Self-Expanding NAVITOR Transcatheter Heart Valve with Its Predecessor, the PORTICO, in Severe Native Aortic Valve Stenosis.新一代自膨胀式NAVITOR经导管心脏瓣膜与其前代产品PORTICO用于重度原发性主动脉瓣狭窄的比较。
J Clin Med. 2023 Jun 12;12(12):3999. doi: 10.3390/jcm12123999.
2
30-Day Clinical Outcomes of a Self-Expanding Transcatheter Aortic Valve: The International PORTICO NG Study.经导管自膨式主动脉瓣 30 天临床疗效:国际 PORTICO NG 研究。
JACC Cardiovasc Interv. 2023 Mar 27;16(6):681-689. doi: 10.1016/j.jcin.2023.02.002. Epub 2023 Feb 27.
3
Self-expanding intra-annular versus commercially available transcatheter heart valves in high and extreme risk patients with severe aortic stenosis (PORTICO IDE): a randomised, controlled, non-inferiority trial.自膨式瓣中瓣与商业可用经导管心脏瓣膜在高危和极高危重度主动脉瓣狭窄患者(PORTICO IDE)中的应用:一项随机、对照、非劣效性试验。
Lancet. 2020 Sep 5;396(10252):669-683. doi: 10.1016/S0140-6736(20)31358-1. Epub 2020 Jun 25.
4
Transcatheter Aortic Valve Replacement With a Repositionable Self-Expanding Prosthesis: The PORTICO-I Trial 1-Year Outcomes.经导管主动脉瓣置换术联合可重定位自扩张假体:PORTICO-I 试验 1 年结果。
J Am Coll Cardiol. 2018 Dec 11;72(23 Pt A):2859-2867. doi: 10.1016/j.jacc.2018.09.014. Epub 2018 Sep 24.
5
Comprehensive Echocardiographic Assessment of Normal Transcatheter Valve Function.经导管正常瓣膜功能的综合超声心动图评估。
JACC Cardiovasc Imaging. 2019 Jan;12(1):25-34. doi: 10.1016/j.jcmg.2018.04.010. Epub 2018 Jun 13.
6
Implantation and 30-Day Follow-Up on All 4 Valve Sizes Within the Portico Transcatheter Aortic Bioprosthetic Family.在 Portico 经导管主动脉生物瓣系列中所有 4 种瓣架尺寸的植入和 30 天随访。
JACC Cardiovasc Interv. 2017 Aug 14;10(15):1538-1547. doi: 10.1016/j.jcin.2017.05.021.
7
St Jude Medical Portico valve.圣犹达医疗 Portico 瓣膜。
EuroIntervention. 2012 Sep;8 Suppl Q:Q97-101. doi: 10.4244/EIJV8SQA18.
8
Transcatheter aortic valve replacement with the St. Jude Medical Portico valve: first-in-human experience.经导管主动脉瓣置换术联合圣犹达医疗 Portico 瓣膜:首例人体应用经验。
J Am Coll Cardiol. 2012 Aug 14;60(7):581-6. doi: 10.1016/j.jacc.2012.02.045. Epub 2012 May 30.

NAVITOR经导管主动脉瓣置换系统的综合评估

A Comprehensive Evaluation of the NAVITOR Transcatheter Aortic Valve Replacement System.

作者信息

Aoun Joe, Zaid Syed, Goel Sachin, Reardon Michael J

机构信息

Cardiovascular Medicine Department, DeBakey Heart & Vascular Center, Houston Methodist Hospital, TX, USA.

Cardiovascular Medicine Department, VA DeBakey Medical Center, TX, USA.

出版信息

Heart Int. 2024 Apr 9;18(1):26-29. doi: 10.17925/HI.2024.18.1.4. eCollection 2024.

DOI:10.17925/HI.2024.18.1.4
PMID:39006462
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11239129/
Abstract

Transcatheter aortic valve replacement (TAVR) has undergone significant advancements in the last two decades, expanding its indications and refining transcatheter heart valve (THV) and delivery system designs to improve procedural success and patient outcomes. This review focuses on the Navitor™ valve, a third-generation intra-annular Portico™ valve (Abbott Structural Heart, St Paul, MN, USA) designed to address TAVR complications, particularly paravalvular leak (PVL). We present an overview of the Navitor™ system, comparing it to the first-generation Portico™ THV in terms of THV design, key iterations and clinical outcomes. The Navitor™ THV introduces two key refinements-a protective outer sealing skirt and a more flexible delivery system. These enhancements have led to a significant reduction in 30 day PVL rates, from 6.3% with the first-generation Portico™ to 0% with the Navitor™ system. Additionally, the Navitor™ system exhibited lower rates of severe bleeding (27.3% versus 13.1%) and major vascular complications (5.8% versus 0.7%) compared with the first-generation Portico™. The Navitor™ valve represents a promising advancement in TAVR technology, with notable reductions in complications such as PVL, severe bleeding, and major vascular issues, compared with its predecessor. While further research is needed to assess long-term durability, these results underscore its potential benefits in enhancing patient outcomes and reducing complications. This review provides insights into the evolving landscape of TAVR technology and its quantifiable impact on patient care.

摘要

在过去二十年中,经导管主动脉瓣置换术(TAVR)取得了重大进展,其适应证不断扩大,经导管心脏瓣膜(THV)和输送系统设计也不断优化,以提高手术成功率和患者预后。本综述聚焦于Navitor™瓣膜,这是一种第三代瓣环内Portico™瓣膜(美国明尼苏达州圣保罗市雅培结构性心脏病公司),旨在解决TAVR并发症,尤其是瓣周漏(PVL)。我们概述了Navitor™系统,并在THV设计、关键迭代和临床结果方面将其与第一代Portico™ THV进行了比较。Navitor™ THV引入了两项关键改进——一个保护性外部密封裙边和一个更灵活的输送系统。这些改进使30天PVL发生率显著降低,从第一代Portico™的6.3%降至Navitor™系统的0%。此外,与第一代Portico™相比,Navitor™系统的严重出血发生率(27.3%对13.1%)和主要血管并发症发生率(5.8%对0.7%)更低。与前代产品相比,Navitor™瓣膜在TAVR技术方面代表了一项有前景的进展,在PVL、严重出血和主要血管问题等并发症方面有显著降低。虽然需要进一步研究来评估长期耐久性,但这些结果强调了其在改善患者预后和减少并发症方面的潜在益处。本综述深入探讨了TAVR技术的不断发展及其对患者护理的可量化影响。