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双动脉狭窄症与无动脉损伤:对外科动脉置换与跨导管动脉置换的考虑

Arthur J Lee¹, Imran Baig¹, Katherine B Harrington¹

¹Baylor Scott and White Heart, The Heart Hospital Plano Plano, TX.

|November 27, 2024

概括

过导管大动脉置换 (TAVR) 为双管大动脉 (BAV) 提供了新的选择,但独特的挑战需要仔细考虑. 本综述指导心脏小组选择最好的终身治疗策略,以治疗BAV狭窄.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
心脏外科手术心脏外科手术

背景情况:

超导管大动脉置换 (TAVR) 现在是大动脉狭窄的关键策略,补充了手术大动脉置换 (SAVR).
大多数临床试验都排除了双主动脉 (BAV) 患者,尽管它们具有独特的解剖学和临床特征.
双主动脉 (BAVs) 存在着不同的挑战,包括多种表型,不断演变的分类和与主动脉病的关联,使治疗决策复杂化.

研究的目的:

审查当前关于在患有双大动脉门 (BAVs) 的患者中管理大动脉狭窄的文献.
概述心脏团队在为BAV患者选择TAVR和SAVR时要考虑的关键因素.
为了指导选择最佳的终身管理策略,为个人与BAV狭窄.

主要方法:

临床试验的文献综述和关于大动脉狭窄治疗的指导方针.
对双主动脉 (BAV) 独特的解剖学和临床特征的分析.
讨论影响BAV狭窄症治疗决策的因素,包括TAVR和SAVR.

主要成果:

双动脉 (BAVs) 由于其解剖学复杂性和相关的动脉变症,需要量身定制的方法.
越来越多地考虑对BAV患者进行过导管大动脉置换 (TAVR),超越高风险人群.
由于缺乏明确的指导方针,需要仔细,个性化评估,以获得最佳的患者管理.

结论:

心脏团队必须在确定双主动脉 (BAV) 狭窄的最佳治疗策略时仔细权衡多种因素.
在BAV治疗中TAVR不断变化的作用需要全面了解患者特异性解剖学和风险.
个性化,终身管理计划对于优化双主动脉 (BAV) 患者的治疗结果至关重要.

关键词:

大动脉狭窄症大动脉狭窄症一个aortopathy的病变.两两的两两的手术上更换大动脉门.通过导管更换大动脉门.

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