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重新定义大动脉置换:从开放式手术过渡到跨导管创新

Frances Lodge¹, Fady Soliman¹, Viswajit Kandula¹

¹Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY 10032, USA.

Journal of clinical medicine

|October 16, 2025

概括

大动脉置换 (AVR) 已经从开放式手术发展到微创和透导管选择. 门技术和个性化规划方面的持续创新对于优化AVR患者的治疗结果至关重要.

科学领域:

心血管外科心血管外科
生物医学工程生物医学工程
干预心脏病学干预心脏病学

背景情况:

大动脉置换 (AVR) 已经发生了显著的进化,从传统的开放心脏手术转向了不那么侵入性的方法.
关键的进步包括机械门,生物假体门,门节约技术和罗斯手术.

研究的目的:

审查大动脉置换的历史进展和技术创新.
讨论不同AVR方法和门类型的比较优势和局限性.
探索AVR的未来方向,包括跨导管大动脉置换 (TAVR) 和AI集成.

主要方法:

关于AVR的历史和技术进步的文献综述.
分析临床试验数据 (例如,PARTNER,Core Valve) 用于跨导管大动脉置换 (TAVR).
讨论AVR技术当前的挑战和新出现的解决方案.

主要成果:

机械提供耐用性,但需要抗凝;生物假体避免抗凝,但寿命有限.
超导管大动脉置换 (TAVR) 现在适用于所有风险概况,证明了安全性和有效性.
在TAVR的挑战包括准膜泄漏,心脏起器植入,和长期耐用性问题,特别是在年轻的患者.

结论:

新型门设计,门中的门程序和抗化处理正在解决当前TAVR的局限性.
人工智能和个性化规划准备好增强未来的AVR结果.
个性化的患者选择和多学科的方法仍然是成功的AVR至关重要的.

关键词:

透过导管的大动脉替换 (TAVR)大动脉狭窄症 (大动脉狭窄症)大动脉门更换 (AVR)生物假体门的使用机械门机械门结构变性 (SVD) 是一种结构性变性.手术上更换大动脉门 (SAVR)门中的门 (ViV)

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