期刊
JACC-CARDIOVASCULAR INTERVENTIONS
卷 14, 期 11, 页码 1169-1180出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcin.2021.03.058
关键词
low-risk TAVR; surgical aortic valve replacement; TAVR in young patients; transcatheter aortic valve replacement
资金
- AstraZeneca
- Biotronik
- Boston Scientific
- Chiesi
TAVR is approved for patients of all risk profiles and ages, but has not been systematically tested in young, low-risk patients. Unanswered questions remain regarding safety and effectiveness in specific patient populations, future treatments, and technical considerations for TAVR. The authors predict a shift towards less invasive treatments due to patient preferences.
Transcatheter aortic valve replacement (TAVR) is approved for all patient risk profiles and is an option for all patients irrespective of age. However, patients enrolled in the low- and intermediate-risk trials were in their 70s, and those in the high-risk trials were in their 80s. TAVR has never been systematically tested in young (<65 years), low-risk patients. Unanswered questions remain, including the safety and effectiveness of TAVR in patients with bicuspid aortic valves; future coronary access; durability of transcatheter heart valves; technical considerations for surgical transcatheter heart valve explantation; management of concomitant conditions such as aortopathy, mitral valve disease, and coronary artery disease; and the safety and feasibility of future TAVR-in-TAVR. The authors predict that balancing these questions with patients' clear preference for less invasive treatment will become common. In this paper, the authors consider each of these questions and discuss risks and benefits of theoretical treatment strategies in the lifetime management of young patients with severe aortic stenosis. (C) 2021 by the American College of Cardiology Foundation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据