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首页> 外文期刊>Cardiology in review >Percutaneous transcatheter aortic valve implantation: Past accomplishments, present achievements and applications, future perspectives
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Percutaneous transcatheter aortic valve implantation: Past accomplishments, present achievements and applications, future perspectives

机译：经皮经导管主动脉瓣植入术：过去的成就，现在的成就和应用，未来的前景

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Surgical aortic valve replacement remains the gold standard for the treatment of severe, symptomatic aortic stenosis. However, percutaneous treatments are challenging this paradigm in high-risk surgical patients. Technological developments have been rapid in the field of percutaneous aortic valve intervention. Two devices have been approved for general use in Europe: the Edwards SAPIEN? valve (Edwards Lifesciences, Irvine, CA) and the CoreValve ReValving? System (CoreValve ReValving? Technology Medtronic Inc., Minneapolis, MN), with 15 potential new designs for percutaneous aortic valves in development around the world. Both systems can be delivered via the transfemoral, transapical and the axillary/subclavian routes, depending upon patient characteristics, anatomy, and the device available to the operator. Careful selection of appropriate patients is essential to ensure a safe procedure. This necessitates a multidisciplinary approach, with multiple imaging modalities used to fully delineate the peripheral vasculature, aortic anatomy and the valve itself. It is important to remember, however, that just because we can treat aortic valve disease percutaneously, it does not mean that we necessarily should. The gold standard treatment for aortic stenosis remains thoracotomy and surgical replacement of the valve; to this end it is essential that surgeons play a central role in the decision-making processes for transcatheter aortic valve implantation and that they embrace this new and exciting technology, which promises to dramatically change the way their high-risk aortic valve patients are managed over the course of the next 10 years.
机译：外科主动脉瓣置换术仍然是治疗严重，症状性主动脉瓣狭窄的金标准。但是，在高危手术患者中，经皮治疗正挑战这种范例。在经皮主动脉瓣介入领域，技术发展迅速。有两种设备已获准在欧洲通用：Edwards SAPIEN？阀门（Edwards Lifesciences，加州欧文）和CoreValve ReValving？系统（明尼苏达州明尼阿波利斯市的CoreValve ReValving？Technology Medtronic Inc.），在全球范围内有15种潜在的经皮主动脉瓣膜新设计。两种系统均可通过股骨，经心尖和腋窝/锁骨下途径输送，具体取决于患者的特征，解剖结构和操作员可用的设备。仔细选择合适的患者对于确保手术安全至关重要。这就需要采取多学科的方法，并采用多种成像方式来全面描绘外周脉管系统，主动脉解剖结构和瓣膜本身。重要的是要记住，仅仅因为我们可以经皮治疗主动脉瓣膜疾病，并不意味着我们一定要这样做。主动脉瓣狭窄的金标准治疗仍然是开胸手术和瓣膜的外科置换。为此，至关重要的是，外科医生在经导管主动脉瓣膜植入的决策过程中发挥核心作用，并且他们必须接受这项令人振奋的新技术，这有望显着改变其高风险主动脉瓣膜患者的治疗方式未来十年的历程。

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