经导管主动脉瓣置换术,目前已成为主动脉瓣重度狭窄高危患者的一种新的有效替代治疗手段.由于二叶式主动脉瓣伴重度钙化性狭窄的患者其瓣叶特殊病理及解剖特点,对于这类患者,经导管主动脉瓣置换术在传统观点中被认为是相对禁忌的,但近期部分案例及研究报道了这部分患者该手术治疗的安全性和有效性,并且手术成功案例也越来越多,目前还无充足的临床研究及证据提示二叶瓣患者能否应用经导管主动脉瓣置换术治疗,以及治疗后的安全性、有效性、瓣膜耐久性及术后并发症的相对优越性,但这必将为其在扩大治疗适应证方面提供新的应用前景.%Transcatheter aortic valve replacement (TAVR) has now become a new and effective alternative to severe aortic valve stenosis. Due to the special pathology and anatomic characteristics of the valve leaflets in patients with severed calcified stenosis of the bicuspid aortic valve, TAVR surgery is considered to be relatively contraindicated in the traditional view of these patients. However, some recent cases and studies have reported the safety and effectiveness of TAVR procedure in these patients, accompany with the increasing number of successful cases. At present, there are not enough clinical studies and evidence to show whether patients with bicuspid aortic valve can be treated with TAVI, as well as the relative superiority of safety, efficacy, valve durability, and postoperative complications after treatment. However, it will certainly provide new application prospects for the expansion of therapeutic indications for TAVR procedure.
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