Vlachakis Panayotis K, Theofilis Panagiotis, Kachrimanidis Ioannis, Soulaidopoulos Stergios, Apostolos Anastasios, Skalidis Ioannis, Karakasis Paschalis, Ktenopoulos Nikolaos, Drakopoulou Maria, Synetos Andreas, Tsioufis Costas, Toutouzas Konstantinos
1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Institut Cardiovasculaire Paris-Sud, Hôpital Jacques Cartier, Ramsay-Santé, 91300 Massy, France.
J Clin Med. 2025 Aug 9;14(16):5651. doi: 10.3390/jcm14165651.
Transcatheter aortic valve implantation (TAVI) has transformed the treatment of aortic valve stenosis, offering a less invasive alternative to surgical valve replacement, particularly in elderly and high-risk populations. As TAVI expands into younger, lower-risk patients, the choice of transcatheter heart valve has become increasingly important to optimize both immediate and long-term outcomes. Currently, Self-Expandable Valves (SEVs) and Balloon-Expandable Valves (BEVs) are the two most widely used platforms, each characterized by distinct design features, implantation techniques, and hemodynamic profiles. While no definitive evidence supports the overall superiority of one valve type over the other, accumulating clinical data highlight specific advantages and limitations depending on anatomical and procedural contexts. This review aims to present and critically discuss the current evidence, clinical considerations, and evolving concerns surrounding the use of SEVs versus BEVs, with a particular focus on challenging scenarios such as valve-in-valve procedures and long-term valve strategy planning.
经导管主动脉瓣植入术（TAVI）改变了主动脉瓣狭窄的治疗方式，为外科瓣膜置换提供了一种侵入性较小的替代方法，尤其适用于老年和高危人群。随着TAVI扩展到更年轻、风险较低的患者，经导管心脏瓣膜的选择对于优化近期和长期疗效变得越来越重要。目前，自膨胀瓣膜（SEV）和球囊扩张瓣膜（BEV）是两种使用最广泛的平台，每种平台都具有独特的设计特点、植入技术和血流动力学特征。虽然没有确凿证据支持一种瓣膜类型总体优于另一种，但越来越多的临床数据根据解剖和手术情况突出了特定的优势和局限性。本综述旨在介绍并批判性地讨论当前关于SEV与BEV使用的证据、临床考虑因素以及不断演变的问题，特别关注诸如瓣中瓣手术和长期瓣膜策略规划等具有挑战性的情况。
