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重新透气管大动脉置换:当第一次透气管大动脉置换失败时的策略

Nils Perrin^1,2, Anita W Asgar¹

¹Department of Cardiology, Montreal Heart Institute Montreal, Canada.

|November 27, 2024

概括

过导管大动脉置换 (TAVR) 是严重的大动脉狭窄症的标准. 本审查审查了TAVR门的耐用性和管理生物假体门故障的策略,包括重复TAVR.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
生物医学工程生物医学工程

背景情况:

透管大动脉置换 (TAVR) 是对症状严重的大动脉狭窄的主要治疗方法,特别是在高风险患者中.
最近的指导方针将TAVR的适用范围扩大到65-80岁的较低风险患者,并将重点放在长期门耐用性上.
生物假体门故障在不断扩大的TAVR人群中越来越令人担忧,需要重新干预的战略.

研究的目的:

在TAVR后审查生物假体门功能障碍.
总结目前关于失败TAVR的重新干预的数据,包括重复TAVR和手术选择.
为患有TAVR门衰竭的患者提出评估和管理框架.

主要方法:

对TAVR门耐用性和故障研究的文献综述.
对TAVR后的重复TAVR和外科门更换现有数据的分析.
综合证据以开发临床决策方法.

主要成果:

随着时间的推移,生物假体TAVR门可能会发生故障,这将对患者的管理产生影响.
重新TAVR是管理失败的TAVR的一个新兴选择,累积的证据支持其可行性和有效性.
对于特定的患者个人资料,外科门或扩张仍然是可行的选择.

结论:

随着患者人数的扩大,TAVR门的长期耐用性至关重要.
需要一个结构化的方法来评估怀疑TAVR门故障的患者.
重复TAVR和手术干预是管理生物假体门衰竭的重要治疗选择.

关键词:

重新通透导管的大动脉替换术冠状动脉阻塞冠状动脉阻塞穿透导管的心脏门失效门的耐用性门的耐用性

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