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经导管主动脉瓣置换

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Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation Association of Smoking Status With Long‐Term Mortality and Health Status After Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry Timing of intervention in asymptomatic patients with valvular heart disease Clinical Impact of Valvular Heart Disease in Elderly Patients Admitted for Acute Coronary Syndrome: Insights From the Elderly-ACS 2 Study Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement Is Not Associated With Increased Early or Late Readmission Risk Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients Minimizing Permanent Pacemaker Following Repositionable Self-Expanding Transcatheter Aortic Valve Replacement Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Timing of Intervention in Aortic Stenosis Cardiac surgery following transcatheter aortic valve replacement
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GuidelineJuly 21, 2021

JOURNAL：JAMA Cardiol. Article Link

Guideline Update on Indications for Transcatheter Aortic Valve Implantation Based on the 2020 American College of Cardiology/American Heart Association Guidelines for Management of Valvular Heart Disease

TM Sundt; H Jneid et al. Keywords: TAVR; valular heart disease; indication; guideline

ABSTRACT

The continued evolution of transcatheter aortic valve implantation (TAVI) technology and the results of multiple randomized clinical trials (RCTs) have firmly established this approach as an alternative to surgical aortic valve replacement (SAVR) in the treatment of aortic stenosis in all risk groups. Deciding on TAVI or SAVR depends on patient-specific factors, including technical, procedure-specific contraindications and the balance between estimated life expectancy and anticipated prosthesis durability. These factors pertain to the decision between mechanical and biological prostheses, and if the choice is biological, between SAVR and TAVI. A strong emphasis is now placed on shared decision-making with the patient and involvement of the multidisciplinary heart team. For most patients younger than 65 years, SAVR is recommended, with mechanical valves favored in those younger than 50 years. For those older than 65 years, the perioperative risks of mortality and stroke are lower with transfemoral TAVI compared with SAVR, but the risks of paravalvular leak, a pacemaker requirement, and vascular complications are higher.
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