Graphical Abstract

Graphical AbstractManagement of severe symptomatic aortic stenosis over the decades. Left upper panel: 1980–1990. Valve replacement reverses the dismal outcome of severe symptomatic AS (adapted from Horstkotte and Loogen³). Right upper panel: 1990–2000. Many patients do not receive AVR because of older age and comorbidities (graph based on data from Charlson et al.,⁵ Iung et al.,⁶ and Bouma et al.⁷). Left lower panel: 2000–2010. TAVI evolves as an alternative to SAVR, RCTs demonstrate non-inferiority (adapted from Jorgensen et al.¹³ and Makkar et al.¹⁴). Right lower panel: 2010–2020. The number of AVRs more than doubles and in-hospital mortality decreases for SAVR and TAVI. AS, aortic stenosis; AVR, aortic valve replacement; RCT, randomized controlled trial; TAVI, transcatheter aortic valve implantation; TAVR, transcatheter aortic valve replacement.

中文翻译：

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2021年的主动脉瓣狭窄管理：比专业之间的斗争更好的合作

图形概要

几十年来严重症状性主动脉瓣狭窄的图形摘要管理。左上图：1980–1990。瓣膜置换可逆转严重症状性 AS 的惨淡结局（改编自 Horstkotte 和 Loogen ³）。右上图：1990–2000。由于年龄较大和合并症，许多患者未接受 AVR（图表基于 Charlson等人5 ^Iung等人6^和Bouma等人7^的数据）。左下图：2000–2010。TAVI 演变为 SAVR 的替代方案，RCT 证明了非劣效性（改编自 Jorgensen等人13^和Makkar等人¹⁴）。右下面板：2010–2020。SAVR 和 TAVI 的 AVR 数量增加了一倍多，院内死亡率降低。AS，主动脉瓣狭窄；AVR，主动脉瓣置换术；RCT，随机对照试验；TAVI，经导管主动脉瓣植入术；TAVR，经导管主动脉瓣置换术。