Transcatheter aortic valve replacement: clinical researches and progress of application

• Main Author: JIN Jun
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2019-10-01
• Series: Di-san junyi daxue xuebao
• Subjects: transcatheter aortic valve replacement; surgical aortic valve replacement; aortic stenosis; complications
• Online Access: http://aammt.tmmu.edu.cn/Upload/rhtml/201906158.htm

In the past decade, interventional cardiology has been revolutionized by transcatheter aortic valve replacement (TAVR), which has been developing greatly and become the preferred treatment for severe symptomatic aortic stenosis (AS) patients with high surgical risk, and for those contraindicated to surgical aortic valve replacement (SAVR). With improvements in devices and technology and increasing experience of operators, TAVR has gained wide acceptance and been applied extensively. It has been demonstrated that the primary composite end point in TAVR group was not inferior to SAVR in AS patients with intermediate operative risk, and the outcomes were even better than SAVR in the transfemoral TAVR subgroup. Meanwhile, in recent, evidence shows the non-inferiority of TAVR to SAVR in low-risk severe AS patients. With the development of TAVR, more attentions have been paid to the application of TAVR in patients with bicuspid aortic valve stenosis, degenerated aortic surgical bioprosthese and pure severe aortic regurgitation, in which the efficacy and safety of TAVR are promising. However, the major complications of TAVR have proved to be prognostic factors. How to reduce the incidence of major complications, such as coronary obstruction, stoke, paravalvular leak, conduction disorders and vascular complications, is hot research topic of future studies, which will benefit more patients with aortic valve diseases.