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经导管主动脉瓣置换

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Prevalence and Outcomes of Concomitant Aortic Stenosis and Cardiac Amyloidosis Bioprosthetic valve oversizing is associated with increased risk of valve thrombosis following TAVR Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives
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Review Article2020 Nov, 13 (21) 2453–2466

JOURNAL：J Am Coll Cardiol. Article Link

Delirium After TAVR: Crosspassing the Limit of Resilience

Kvan der Wulp , MH van Wely , MJP Rooijakkers et al. Keywords: delirium; post TAVR

ABSTRACT

Patients who undergo transcatheter aortic valve replacement often are frail and elderly. Delirium is a frequently observed complication, associated with impaired recovery, prolonged hospital stay, and mortality. In different hospital settings, interventions that reduced the incidence of delirium resulted in improved clinical outcome and reduced costs. In that context, prevention, early recognition, and timely interventions could be the next step toward better outcomes of transcatheter aortic valve replacement. This review is focused on awareness and recognition of delirium, including predisposing “vulnerability” factors (such as cognitive impairment and carotid artery disease) and “trigger” factors (such as anesthesia, hemodynamic imbalance, and complications). For prevention and treatment, clinicians should focus on sleep hygiene, orientation, pain management, and early mobilization. In case of delirium, a thorough search and treatment of trigger factors is warranted. Future studies should focus on risk assessment, preventive and therapeutic interventions, and their potential benefit in terms of costs and clinical outcomes.
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