8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

1/37

?

XGXCL0 Xtoerboxjlxlt Ontxgb Yocyl Tlvcoblalex Ge Voxglexr [gxj Rlyltl

Ontxgb Rxlenrgr [jn Boeenx \ehltkn R|tkltw

O\XJNT0 @liitlw O% Xgbl# AH

Orrgrxoex Vtnilrrnt ni Alhgbgel

Hgygrgne ni Kleltoc Gexlteoc Alhgbgel

Hlvotxalex ni Alhgbgel

\egyltrgxw ni Bocgintego Roe Itoebgrbn

V\DCGRJLT0 Bocgintego Xlbjencnkw Orrlrralex Int|a

HOXL NI V\DCGBOXGNE0 Ildt|otw :# 46?4

VCOBL NI V\DCGBOXGNE0 Roe Itoebgrbn# BO

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

2/37

4

XTOERBOXJLXLT ONTXGB YOCYL TLVCOBLALEX GE VOXGLEXR [GXJ RLYLTL ONTXGB RXLENRGR

[JN BOEENX \EHLTKN R\TKLTW

O Xlbjencnkw Orrlrralex

GEXTNH\BXGNE

Xjl Bocgintego Xlbjencnkw Orrlrralex Int|a *BXOI' {or ormlh xn orrlrr xjl lyghlebl int xjl |rl ni

xtoerboxjlxlt ontxgb yocyl tlvcoblalex int xjl xtloxalex ni voxglexr {gxj ontxgb rxlenrgr {jn otl enx r|tkgboc

boehghoxlr% Ontxgb rxlenrgr gr xtloxlh alhgboccw |exgc xjl yocyl otlo hlbtlorlr xn o btgxgboc vngex nt xjl

voxglex dlbnalr rwavxnaoxgb% Dlbo|rl yocy|cot ontxgb rxlenrgr gr vtgaotgcw o hgrlorl ni okgek# aoew

voxglexr {gxj ontxgb rxlenrgr joyl rgkegigboex bn!antdghgxglr xjox vtlbc|hl r|tkgboc gexltylexgne% Xjl IHO

tlblexcw ovvtnylh oe ontxgb yocyl tlvcoblalex hlygbl xjox boe dl gavcoexlh {gxjn|x tlq|gtgek o alhgoe

rxltenxnaw oeh bothgnvclkgo%

DOBMKTN\EH

Yocy|cot ontxgb rxlenrgr

Ontxgb rxlenrgr *OR' gr o hlbtlorl ge xjl liilbxgyl otlo ni xjl ontxgb yocyl clohgek xn gebtlorlh tlrgrxoebl xn

xjl icn{ ni dcnnh obtnrr xjl yocyl%?#4Gx gr tlcoxgylcw bnaane ge xjl lchltcw {gxj o vtlyoclebl dlx{lle 8, oeh

Xjl bothgeoc rwavxnar ni ontxgb rxlenrgr otl oekgeo# bneklrxgyl jlotx iogc|tl# oeh rwebnvl% Bcorrgboccw#

xjlrl nbb|t h|tgek lzltbgrl dlbo|rl xjl clix ylextgbcl gr |eodcl xn v|rj r|iigbglex dcnnh obtnrr xjl rxlenxgb

yocyl xn allx xjl hlaoehr ni xjl jlotx oeh xjl tlrx ni xjl dnhw% R|tkltw gr gehgboxlh nebl rnalnel

dlbnalr rwavxnaoxgb dlbo|rl oyltokl r|tygyoc {gxjn|x r|tkltw gr necw x{n xn xjtll wlotr%4#:#7

Xjl rgker ni ontxgb rxlenrgr ne vjwrgboc lzoa gebc|hl o rwrxncgb a|ta|t# |r|occw cn|hlrx ox xjl tgkjx |vvlt

rxlteoc dnthlt# xjox vlomr coxl oeh tohgoxlr xn xjl tgkjx botnxgh otxltw%?6Xjl botnxgh otxltw v|crl gr bcorrgboccw

voty|r lx xoth|r0 {lom oeh coxl% Igeoccw xjl rlbneh jlotx rn|eh aow dl tlh|blh ge gexlergxw%

Xjltl otl xjtll aoge intar ni ontxgb yocyl hgrlorl0 bneklegxoc odentaocgxglr# r|bj or o dgb|rvgh yocyl xjox

clohr xn vtlaox|tl bocbgigboxgne= bocbgigboxgne ni xjl entaoc xtgcloiclx yocyl= oeh tjl|aoxgb yocyl hgrlorl% Ge

xjl \egxlh Rxoxlr odn|x ?6, ni ontxgb rxlenrgr gr bo|rlh dw tjl|aoxgb hgrlorl oeh xjl tlaogehlt dw

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

3/37

2

bocbgigboxgne ni o |egb|rvgh# dgb|rvgh# nt entaoc xtgcloiclx yocyl%??!?8Bocbgigb ontxgb yocyl hgrlorl gr

bjotobxltgplh dw vtnktlrrgyl ontxgb yocyl cloiclx xjgbmlegek oeh bocbgigboxgne xjox tlr|cxr ge o yocyl xjox hnlr

enx i|ccw nvle oeh xj|r votxgoccw ndrxt|bxr xjl icn{ ni dcnnh itna xjl clix ylextgbcl gexn xjl ontxo h|tgek

rwrxncl%

Xjl entaoc ontxgb yocyl otlo {jle nvle gr dlx{lle 2 ba4 oeh 8 ba4% Xjltl gr en rgkegigboex ndrxt|bxgne xn

icn{ |exgc xjl yocyl otlo jor hlbtlorlh dw

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

4/37

8

gebtlorl ge xjl oyltokl okl oeh nvltoxgyl tgrm ni voxglexr%?9#?;Ge xjl Rnbglxw int Xjntobgb R|tklner Eoxgneoc

Bothgob R|tkltw Hoxodorl nvltoxgyl antxocgxw int grncoxlh ontxgb yocyl tlvcoblalex hlbtlorlh itna 2%8, ge

?77; xn 4%9, ge 4669 {jgcl xjl vtlhgbxlh antxocgxw gebtlorlh itna 4%:, xn 2%4, oeh xjl oyltokl okl

gebtlorlh itna 99 wlotr xn 9: wlotr%?9Xjl gebghlebl ni rxtnml ocrn hlbtlorlh itna ?%;, xn ?%2,%?9Xjl

gavtnylalexr {ltl cotklrx ge xjl nchlrx voxglexr% Int lzoavcl# int voxglexr :< xn :7 wlotr nch# nvltoxgyl

antxocgxw ilcc itna ;%:, xn 8%?, oeh xjl rxtnml toxl hlbtlorlh itna 8%?, xn 4%8,%?9Xjlrl e|adltr

tlvtlrlex tlorneodcl dlebjaotmr xjox enylc xjltovl|xgb ovvtnobjlr ellh xn aoxbj ox o agega|a%

Voxglexr {gxj rwavxnaoxgb ontxgb rxlenrgr otl kleltoccw lchltcw oeh nixle joyl nxjlt rgkegigboex alhgboc

gccelrrlr v|xxgek xjla ox jgkj tgrm int vltgnvltoxgyl bnavcgboxgner gebc|hgek hloxj% Xjltl otl x{n tgrm rbntlr

xjox otl {ghlcw |rlh xn orrlrr voxglexr tgrm vtgnt xn r|tkltw% Xjl L|tnvloe Rwrxla int Bothgob Nvltoxgne

Tgrm Lyoc|oxgne *L|tnRBNTL' gr {ghlcw |rlh ge L|tnvl% Gx {or hlylcnvlh dorlh ne ?7#666 bothgob

r|tkltglr vltintalh ge L|tnvl ge ?77

|ehltkn r|tkltw otl hlxltagelh xn joyl bn!antdghgxglr nt oe nyltocc tgrm int vnnt n|xbnalr xjox aomlr

xjla genvltodcl% Xtoerboxjlxlt ontxgb yocyl tlvcoblalex gr o vnxlexgoc cgil!roylt int xjlrl voxglexr%

Xtoerboxjlxlt ontxgb yocyl tlvcoblalex *XOYT'

Xtoerrboxjlxlt ontxgb yocyl tlvcoblalex gr o enylc {ow xn tlvcobl o hgrlorlh ontxgb yocyl {gxjn|x o alhgoe

rxltenxnaw% Xjl igtrx j|aoe XOYT {or vltintalh dw Ht% Btgdglt ge 4664%22Xjltl joyl dlle xjtll

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

5/37

EBOGh14

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

25/37

4 @ XjntobBothgnyorb R|tk% Eny 4667=?2:*?62% Rnxn KL# @nelr V# [lgexto|d [R# Mt|ajncp JA# Rvltx|r @O% Vtnkenrxgb yoc|l ni jlocxj rxox|r gevoxglexr {gxj jlotx iogc|tl oixlt ob|xl awnbothgoc geiotbxgne% Bgtb|coxgne%O|k 2 4668=??6*

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

36/37

29

?69% [otl @# @t%# Mnrgermg A# Mlcclt RH% O ?4!Gxla Rjntx!Inta Jlocxj R|tylw0 bnerxt|bxgne ni rboclroeh vtlcgageotw xlrxr ni tlcgodgcgxw oeh yocghgxw% Alh Botl% Aot ?779=28*2'0446!422%

?6;% [wt{gbj M[# Rvltx|r @O# Mtnleml M# Xgltelw [A# Dod| OE# [ncgermw IH% Bcgegboccw gavntxoex

hgiiltleblr ge jlocxj rxox|r int voxglexr {gxj jlotx hgrlorl0 oe lzvltx bnerler|r voelc tlvntx%OaJlotx @%Ovt 4668=?8;*8'09?

?6:% Clne AD# Vgoppo E# Egmncrmw L# lx oc% Rxoehothgplh lehvngex hligegxgner int Xtoerboxjlxlt OntxgbYocyl tlvcoblalex bcgegboc xtgocr0 o bnerler|r tlvntx itna xjl Yocyl Obohlagb TlrlotbjBnerntxg|a% @n|teoc ni xjl Oaltgboe Bncclkl ni Bothgncnkw% @oe ?: 46??=

8/2/2019 Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis Who Cannot Undergo Surgery

37/37

?46% Copot JC% Xtoerboxjlxlt ontxgb yocylr!{jltl hn {l kn itna jltl> Xjl El{ Lekcoeh `n|teoc nialhgbgel% Nbx 4? 46?6=292*?;'0?99;!?99:%