Transcatheter Aortic Valve Replacement Beyond Severe Aortic Stenosis

被引：6

作者：

Beerkens, Frans J. ^{[1
]}

Tang, Gilbert H. L. ^{[1
,2
]}

Kini, Annapoorna S. ^{[1
]}

Lerakis, Stamatios ^{[1
]}

Dangas, George D. ^{[1
]}

Mehran, Roxana ^{[1
]}

Khera, Sahil ^{[1
]}

Goldman, Martin ^{[1
]}

Fuster, Valentin ^{[1
]}

Bhatt, Deepak L. ^{[1
]}

Webb, John G. ^{[3
]}

Sharma, Samin K. ^{[1
]}

机构：

[1] Mt Sinai Fuster Heart Hosp, New York, NY USA

[2] Mt Sinai Hlth Syst, Dept Cardiovasc Surg, New York, NY USA

[3] St Pauls Hosp, Div Cardiol, Vancouver, BC, Canada

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2025年 / 85卷 / 09期

关键词：

aortic regurgitation; aortic stenosis; asymptomatic; bicuspid aortic valve; transcatheter aortic valve replacement; valve-in-valve; PROSTHESIS-PATIENT MISMATCH; FAILURE MIDTERM OUTCOMES; PARADOXICAL LOW-FLOW; HEART-FAILURE; PROGNOSTIC IMPLICATIONS; ANTITHROMBOTIC THERAPY; SURGICAL EXPLANTATION; CLINICAL IMPACT; FOLLOW-UP; TAVR;

D O I：

10.1016/j.jacc.2024.11.051

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Transcatheter aortic valve replacement (TAVR) has become the preferred treatment option in appropriate patients with symptomatic severe aortic stenosis (AS). A number of advancements have since expanded the eligible population to bicuspid aortic valve with feasible anatomy; small aortic annuli; low-flow, low-gradient AS; and younger patients. Focus has also shifted beyond the symptomatic severe patients to asymptomatic severe and moderate AS, as early valve replacement may prevent irreversible cardiac remodeling. Dedicated devices to treat native aortic regurgitation have shown encouraging short-term outcomes. While the expansion of TAVR to younger patients has raised questions about valve durability and feasibility of reintervention, valve-in-valve TAVR has thus far shown encouraging midterm results. In this review, we summarize the evidence in these contemporary TAVR populations, exploring both the promise and challenge of broadening the patient pool for this minimally invasive procedure. (JACC. 2025;85:944-964) (c) 2025 by the American College of Cardiology Foundation.

引用

页码：944 / 964

页数：21

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