合并冠心病的经导管主动脉瓣置换术患者管理及处理策略

Management and treatment of concomitant coronary artery disease in patients undergoing transcatheter aortic valve replacement

经导管主动脉瓣置换术(TAVR)应用范围已从高龄、外科手术高危的重度主动脉瓣狭窄(AS)患者扩展至较年轻的、低危的重度AS患者。多项研究显示,TAVR患者中冠心病的发病率较高,值得注意的是,这些关注TAVR患者的研究对冠心病的纳入标准并不统一。TAVR患者的冠状动脉病变是否需要进行处理、何时处理、如何处理等问题相关数据信息尚少。本文对合并冠心病的TAVR患者的管理及处理策略进行探讨。

Transcatheter aortic valve replacement(TAVR)has led to a paradigm shift treatment of severe aortic stenosis(AS)in the elderly and is expanding to still younger and lower-risk patient groups.The prevalence of coronary artery disease(CAD)in patients undergoing TAVR is reported high.However,a large variation in the definition of CAD between studies.Meanwhile,important unresolved questions are if,how,and when to treat co-existing CAD.Up to now,data on these pivotal questions are few.The aim of this review is to provide an overview of the management and treatment strategy of patients planned for TAVR and co-existing CAD.