大動脈弁疾患の管理戦略と将来の課題
Robert O Bonow1, Martin B Leon2, Darshan Doshi2
1Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Lancet (London, England)
|March 31, 2016
まとめ
精密な診断と手術またはトランスキャテーターによる大動脈弁置換を含む早期の介入は,大動脈弁疾患のアウトカムを改善します. トランスキャテーターによるアプローチは,特に大動脈狭窄の高リスク患者に拡大しています.
科学分野:
- 心臓病科
- 心血管外科
- 医療用イメージング
背景:
- 大動脈弁の病気の管理は 診断ツールと治療タイミングの改善によって進歩しました
- 加熱性大動脈狭窄症の罹患率は高齢者集団で増加しています.
- トランスキャテーター大動脈弁置換 (TAVR) は,特に高リスクの手術候補者のために拡大しています.
研究 の 目的:
- 大動脈弁の病気の診断と管理の進歩をレビューする.
- 重症度と進行を評価する際のエコーカルディオグラフィと高度なイメージングの役割について議論する.
- 手術や経路経路の選択肢を含む 進化する治療環境を強調する.
主な方法:
- 大動脈弁疾患の診断と管理に関する現在の文献のレビュー.
- 重症度評価のためのエコーカーディオグラフィと高度なイメージング技術の分析.
- 手術とトランスキャテーターによる大動脈弁置換の戦略の評価
主要な成果:
- 正確な診断と評価は,大動脈弁置換の最適なタイミングに不可欠です.
- 従来の手術は標準ですが 高リスクの患者には TAVR が確立されています
- トランスキャテーターによる大動脈吐は 独特の課題です
結論:
- 診断の精度と早期の介入により,大動脈弁の疾患の管理が向上します.
- 経管性大動脈弁の置換は技術的進歩と臨床的証拠により急速に増加しています.
- 大動脈吐に対するトランスキャセター治療のさらなる開発が必要である.
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