Abstract:
In an era of rapidly expanding use of transcatheter aortic valve implantation (TAVI), the management of patients with bicuspid aortic valve (BAV) disease is far less well established than in those with trileaflet anatomy. Results of isolated surgical aortic valve replacement are excellent in suitable patients, and surgery also allows treatment of concomitant pathology of the aortic root and ascending aorta that is frequently encountered in this cohort. Conversely, TAVI provides an excellent alternative in older patients who may be unsuitable for surgery, although outcomes in BAV disease have only been reported in relatively small non-randomised series. Here, we discuss the pertinent literature on this topic and outline contemporary interventional treatment options in this challenging setting.
摘要:
在经导管主动脉瓣植入术(TAVI)使用迅速扩大的时代,二叶主动脉瓣(BAV)疾病患者的治疗远不及三叶叶解剖患者.在合适的患者中,孤立的外科主动脉瓣置换术的结果非常好,手术还可以治疗在该队列中经常遇到的主动脉根和升主动脉的伴随病理。相反,TAVI为可能不适合手术的老年患者提供了极好的替代方案,尽管仅在相对较小的非随机系列中报道了BAV疾病的结局。这里,我们讨论了有关该主题的相关文献,并概述了在这种具有挑战性的背景下的当代介入治疗方案。