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在TAV-in-TAV程序中的临床考虑和挑战
Ahmad Hayek1,2, Cyril Prieur2, Nicolas Dürrleman1
1Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada.
Frontiers in cardiovascular medicine
|March 5, 2024
概括
通过导管的大动脉 (TAV) 在TAV程序为需要重复大动脉治疗的患者提供了不那么侵入性的选择. 本综述探讨了TAV中的TAV数据,规划,挑战以及这一新兴技术的未来方向.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 透导管大动脉置换 (TAVR) 是对大动脉疾病的常见治疗方法,即使在低风险患者中也是如此.
- 越来越多的TAVR使用引发了人们对长期门耐用性和重新干预的需要的担忧.
- 透气管大动脉 (TAV) -in-TAV手术正在成为对失败的TAVR器件进行探索的不那么病态的替代方案.
研究的目的:
- 对TAV-in-TAV程序的现有经验和现有数据进行全面审查.
- 讨论TAV-in-TAV的基本程序前规划考虑因素.
- 突出挑战,强调冠状动脉阻塞评估,并提供未来对TAV中的TAV的洞察力.
主要方法:
- 对有关TAV-in-TAV程序的现有文献和注册表数据进行系统审查.
- 对手术前成像和规划策略的分析.
- 评估程序的结果,并发症和长期耐用性.
主要成果:
- 在选定的患者群体中,TAV-in-TAV程序已经证明了可行性和有希望的结果.
- 有效的程序前规划,包括详细的成像,对于成功的TAV-in-TAV至关重要.
- 冠状动脉阻塞是一个关键的挑战,需要仔细评估和管理策略.
结论:
- TAV-in-TAV是管理失败的TAVR的一个有价值的选择,可能可以避免更复杂的手术.
- 需要进一步的研究和技术标准化,以优化TAV-in-TAV的结果.
- 该技术在未来对退化的TAVR门的管理具有显著的潜力.
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