最近获得专利并广泛应用于经导管主动脉瓣植入术。

Siyamek Neragi-Miandoab, Edvard Skripochnik, Robert E Michler
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引用次数: 7

摘要

主动脉瓣狭窄(AS)是美国和欧洲老龄化人群中的一种严重疾病。瓣膜狭窄的处理是至关重要的,因为它可以迅速成为症状,导致心室恶化和整体生活质量下降。考虑到AS是一种老年患者群体的疾病,一些患者可能无法很好地耐受手术干预。经导管主动脉瓣植入术(TAVI)已成为不适合手术患者的替代方法。自Cribier博士植入第一个可膨胀的Edwards SAPIEN瓣膜(Edwards Lifesciences, Irvine, CA)以来,许多其他瓣膜已被引入临床实践。自膨胀阀是最常用的自膨胀阀,如用于逆行植入的CoreValve revalve系统(Medtronic, Minneapolis, MN)和用于顺行和经尖植入的Symetis TX。另一方面,SAPIEN瓣膜既可以逆行植入,也可以顺行植入。总的来说,最广泛使用的瓣膜是爱德华兹SAPIEN和CoreValve,它们已经植入了全球超过40,000名患者。Symetis阀门在欧洲的小批量生产中显示出良好的效果,并可能在不久的将来引入美国市场。本文将回顾这3个最近获得专利的瓣膜,并讨论一些可用的临床结果。
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Recently patented and widely used valves for transcatheter aortic valve implantation.

Aortic stenosis (AS) is a serious condition in the aging US and European populations. Management of a stenotic valve is crucial as it can become symptomatic quickly leading to ventricular deterioration and overall poor quality of life. Considering that AS is a disease of the elderly patient population, surgical intervention may not be well tolerated by some patients. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative approach for patients who are unsuitable surgical candidates. Since the first balloon-expandable Edwards SAPIEN valve (Edwards Lifesciences, Irvine, CA) was implanted by Dr. Cribier, many other valves have been introduced into clinical practice. Self-expanding valves such as the CoreValve ReValving system (Medtronic, Minneapolis, MN) for retrograde implantation and Symetis TX for antegrade and transapical implantation are the most frequently used self-expanding valves. The SAPIEN valve, on the other hand can be implanted both antegrade as well as retrograde. Overall, the most widely used valves are the Edwards SAPIEN and the CoreValve, which have been implanted in more than 40,000 patients worldwide. The Symetis valve has shown promising results in small series in Europe and may be introduced to the US market in the near future. This manuscript will review these 3 recently patented valves and discuss some of the clinical results that are available.

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