Abstract:
:Aortic stenosis is the most common valvular disease worldwide. With transcatheter aortic valve replacement (TAVR) being increasingly expanded to lower-risk populations, several challenging issues remain to be solved. The present review aims at discussing modern approaches to such issues as well as the current status of TAVR. TAVR has undergone several developments in the recent years: an increased use of transfemoral access, the development of prostheses in order to adapt to challenging anatomies, improved delivery systems with repositioning features, and outer skirts aiming at reducing paravalvular leak. The indication of TAVR is increasingly being expanded to patients with lower surgical risk. The main clinical trials supporting such expansion are reviewed and the latest data on low-risk patients are discussed. A number of challenges need still to be addressed and are also reviewed in this paper: the need for updated international guidelines including the latest evidence; a reduction of main complications such as permanent pacemaker implantation, paravalvular leak, and stroke (and its potential prevention by using anti-embolic protection devices); the appropriate role of TAVR in patients with concomitant cardiac ischemic disease; and durability of bio-prosthetic implanted valves. Finally, the future perspectives for TAVR use and next device developments are discussed.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Mas-Peiro S,Fichtlscherer S,Walther C,Vasa-Nicotera Mdoi
10.21037/jtd.2020.01.10subject
Has Abstractpub_date
2020-04-01 00:00:00pages
1665-1680issue
4eissn
2072-1439issn
2077-6624pii
jtd-12-04-1665journal_volume
12pub_type
杂志文章,评审abstract::Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vasc...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.08.50
更新日期:2017-09-01 00:00:00
abstract::Transcatheter aortic valve implantation is an important therapeutic option for patients with symptomatic, severe aortic stenosis at increased risk for open surgical aortic valve replacement. Although a number of alternative vascular access sites have been developed, transfemoral access is overwhelmingly the dominant a...
journal_title:Journal of thoracic disease
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journal_title:Journal of thoracic disease
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doi:10.21037/jtd.2016.02.51
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abstract:BACKGROUND:Previously, most studies did not discuss about the characteristics of lung-involved toxocariasis without eosinophilia. However, the patients are not always accompanied by eosinophilia, so it is necessary to learn about the clinical and radiologic features that may predict pulmonary toxocariasis without eosin...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.12.24
更新日期:2014-12-01 00:00:00
abstract::Patients with locally advanced esophageal cancer are treated with definitive chemoradiation (dCXRT) for a number of reasons. Some patients are never referred to a surgeon for a con-versation about surgery, others decline surgery, and some are not candidates for surgery due to a sag in performance status secondary to t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.03.29
更新日期:2014-05-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2016.02.27
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.07.10
更新日期:2015-07-01 00:00:00
abstract::The new drugs delamanid and bedaquiline are increasingly used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB). As evidence is lacking, the World Health Organization recommends their use under specific conditions in adults, delamanid only being recommended in children ≥6 years o...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.06.16
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.08.100
更新日期:2019-09-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.10.19
更新日期:2018-01-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.11.81
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Existing medical treatments have limitations in the management of very severe chronic obstructive pulmonary disease (COPD). METHODS:We performed bronchoscopic lung volume reduction (BLVR) using transbronchial infusion of autologous blood and thrombin (BLVR with blood) in three patients with very severe COPD...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.01.10
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:We hypothesized that pretreatment with sivelestat therapy could attenuate ventilator-induced lung injury (VILI) and lung inflammation in a rat model. METHODS:The neutrophil elastase inhibitor was administered intraperitoneally 30 min before and at the initiation of ventilation. The rats were categorized as (...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.11.10
更新日期:2014-12-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2013.08.43
更新日期:2013-10-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.10.52
更新日期:2016-10-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2014.07.05
更新日期:2014-08-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 评论,社论
doi:10.21037/jtd.2017.03.48
更新日期:2017-03-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd-2020-icc-002
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type:
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
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更新日期:2017-01-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2014.03.20
更新日期:2014-05-01 00:00:00
abstract:Background:High levels of thymidylate synthase (TS) and dihydrofolate reductase (DHFR) expression in tumour tissues are an indicator of ineffective responses to pemetrexed-based chemotherapy in various tumours, including non-small cell lung cancer (NSCLC). However, tumour tissues are highly heterogeneous, so a single b...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd-20-3185
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Visceral pleural invasion (VPI) had been demonstrated as an aggressive sign in non-small cell lung cancers (NSCLC). However, its incidence and clinical relevance in early lung cancer showing ground glass nodules (GGNs) has not been clarified. METHODS:All consecutive surgically treated patients with solitary...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.05.90
更新日期:2016-07-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.10.41
更新日期:2019-10-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 社论
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更新日期:2017-05-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.91
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.01.32
更新日期:2019-02-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.135
更新日期:2018-03-01 00:00:00