跨导管大动脉植入的指示和患者的选择
Jonathan Curio1,2, Henning Guthoff1,2, Stephan Nienaber1,2
1Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Germany.
Interventional cardiology (London, England)
|June 25, 2025
概括
过导管大动脉植入 (TAVI) 现在是严重大动脉狭窄症 (AS) 的主要治疗方法. 指示已经扩大到不仅仅是手术风险,还包括终身管理的患者因素.
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:
- 严重的大动脉狭窄症 (AS) 的管理已经发生了显著的转变.
- 过导管大动脉植入 (TAVI) 从一种替代初级疗法演变为一种主要疗法.
- 最初的TAVI指示是基于高的手术风险.
研究的目的:
- 审查TAVI和外科门置换 (SVR) 指示的演变.
- 讨论影响治疗决策的外科风险之外的因素.
- 要突出转向AS的终身管理方法的转变.
主要方法:
- 临床试验和指导方针的文献综述.
- 对严重AS治疗模式不断变化的分析.
- 讨论治疗选择中的患者特异性因素.
主要成果:
- 现在TAVI是大多数严重AS患者的主要治疗方法,包括低风险和中等风险组.
- 临床决策包括年龄,预期寿命,并发病,解剖学和患者偏好.
- 终身管理策略现在是AS治疗的核心.
结论:
- 在过去的20年里,TAVI的适用范围大大扩大了.
- 最佳的AS治疗选择需要一个全面的,个性化的方法.
- 对于患有严重大动脉狭窄症的患者来说,终身管理至关重要.
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