Cardiothoracic Surgery, Lancashire Cardiac Centre/Blackpool Teaching Hospital, Blackpool, United Kingdom; Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Cardiovascular Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
J Am Coll Cardiol. 2024 Jul 23;84(4):382-407. doi: 10.1016/j.jacc.2024.05.031.
Transcatheter technologies triggered the recent revision of the guidelines that progressively widened the indications for the treatment of aortic stenosis. On the surgical realm, a technology avoiding the need for sutures to anchor the prosthesis to the aortic annulus has been developed with the aim to reduce the duration of cardiopulmonary bypass and simplify the process of valve implantation. In addition to a transcatheter aortic valve replacement (TAVR)-like stent that exerts a radial force, these so-called "rapid deployment valves" or "sutureless valves" for aortic valve replacement also have cuffs to improve sealing and reduce the risk of paravalvular leak. Despite promising, the actual advantage of sutureless valves over traditional surgical procedures (surgical aortic valve replacement) or TAVR is still debated. This review summarizes the current comparative evidence reporting outcomes of "sutureless valves" for aortic valve replacement to TAVR and surgical aortic valve replacement in the treatment of aortic valve stenosis.
经导管技术引发了最近对指南的修订，这些修订逐步扩大了主动脉瓣狭窄治疗的适应证。在心脏外科领域，开发了一种无需缝线将假体固定在主动脉瓣环上的技术，旨在缩短体外循环时间并简化瓣膜植入过程。除了具有径向力的经导管主动脉瓣置换术 (TAVR) 样支架外，这些用于主动脉瓣置换的所谓“快速部署瓣膜”或“无缝线瓣膜”也有袖口，以改善密封并降低瓣周漏的风险。尽管很有前景，但无缝线瓣膜相对于传统手术（心脏外科主动脉瓣置换术）或 TAVR 的实际优势仍存在争议。这篇综述总结了目前关于无缝线瓣膜与 TAVR 和心脏外科主动脉瓣置换术治疗主动脉瓣狭窄的比较结果的证据。
