TAVI的应用进展及长期效果

Long-term result and development of transcatheter aortic valve implantation (TAVI)

经导管主动脉瓣置换术(transcatheter aortic valve implantation,TAVI),通过股动脉、心尖或其他动脉途径送入导管,将人工心脏瓣膜输送至主动脉瓣区打开,从而完成人工瓣膜置换,恢复瓣膜功能。由于其手术无需开胸、创伤小、术后恢复快,即刻及中远期治疗效果显著,受到了目前心血管领域高度关注的新技术,引领了微创心脏外科的新革命。但也因其手术适应症窄,手术技术经验要求高,手术并发症多等因素,使其广泛应用于临床面临着诸多考验。本文对TAVI的应用进展及长期效果,包括适应证的选择、器械及手术人路和手术并发症及中-远期生存率作一综述。

Transcatheter aortic valve implantation(TAVI)is performed by feeding the artificial heart valve into the catheter through femoral artery,apex or other arterial pathways,and then transferring the artificial heart valve to the aortic valve area to open,so as to complete the replacement of the artificial heart valve and restore the function of the valve.Because of its no need for thoraeotomy,minimal trauma,rapid recovery,immediate and long-term treatment remarkable effect,it has been highly concerned by the current cardiovascular field of new technology,leading a new revolution in minimally invasive cardiac surgery.However,because of its narrow surgical indications,high technical experience and many complications,its wide application in clinic is facing many challenges.This article reviews the application progress and long-term effects of TAVI,including the selection of indications,instruments and surgical approaches,surgical complications and medium-to-long-term survival rates.