609
1941298026012657111169
INTERVENČNÍ341804301071978123168215263308366420478499
A8628043010752
AKUTNÍ936804301075299157202263284
KARDIOLOGIE12418043010745103150211232295337397456477520
/18078043010732
Interv188480430107196794136163207
Akut2110804301075391139168
Kardiol.2297804301074588114162181229249264
2023;22(4):194-2002581804301074487128172186230274296337359373410448493522561604650
/32768043010731
www.iakardiologie.cz48438043010765133201214233274312354380428447495515563613632675690730769
PŘEHLEDOVÉ341207012660124182256312369444520587645
ČLÁNKY1008207012660115187259327395
/1424207012633
REVIEW1477207012662121191224282376
ARTICLES1874207012668131191224287342399458
TAVI34136501063066101118
–475365010645
kdy53636501063373109
už66036501063971
ne?7473650106397199
TAVI3409320298132273413480
–8689320298120
kdy10379320298130269393
už14799320298140252
ne?17809320298141266363
Hana3401330013776134199257
Línková620133001375685150210272329387
Kardiologická3401484013360113149210235295321381443468517568622
klinika,98514840133517910316418923929312781460016328
3.1334148401335678
lékařská1435148401332681133186222265316370
fakulta1828148401333386137197223258312
Univerzity21631484013371131156209262298347372408462
Karlovy26491484013359113148174234286341
a30131484013353
Fakultní30901484013353102153213238274335360
nemocnice34731484013361116207268317378403451505
Královské4001148401336097150175235287330380434
Vinohrady,4458148401336188148208269304357419471488
Praha4970148401335893146206258
Transkatétrová340199401214976124179217264312345394427459514560608
implantace9671994012123105161185233288320368413461
aortální14471994012147102135170219242297320
chlopně1786199401214498122176233288338
(TAVI)2142199401212880134185210237
způsobila2398199401214298153192247303327350398
výraznou2814199401214898131179223278332387
změnu32191994012143125175230284
v35221994012147
léčbě3588199401212373118174224
aortální3402134012148103136172221245300324
stenózy683213401213973123178233275326
(AS)1028213401212888138166
a12132134012148
rozšířila1280213401213287129171194230253277325
ji1624213401212448
i16912134012123
pro1733213401215790145
pacienty,18972134012156105150173224279312362378
kteří2295213401214682132165188
by25032134012156102
v26252134012147
minulosti26912134012183106162216240295335369393
nebyli31032134012155105162209233257
indikováni3379213401212378135159205259306355410434
k3402274012146
chirurgické405227401214498122154209241296320364410459
léčbě.882227401212473119175225245
Přes1145227401215284133172
obrovský13362274012154111143198244284330380
přínos1734227401215689113167222261
této2014227401213281115168
metody22012274012182132165219275323
existuje2542227401215096120159193247271321
skupina2882227401213985140196220274322
pacientů,32232274012156104148171221276309363384
kteří3625227401214782131164187
z3402414012143
léčby405241401212475122179226
neprofitují6542414012155107165198254284311345401426450
a11262414012149
u11972414012155
nichž1274241401215680126182226
je1522241401212475
TAVI16202414012149105157183
považována18252414012157114162211256311359409465514
za2361241401214394
zbytečnou.24772414012143101149186236283339395451473
V29732414012155
pivotních3051241401215681130185219275300345401
studiích3474241401214075131188213237282338
u3402554012155
pacientů4152554012157107153177228284318374
s8092554012139
vysokým8682554012148100141197245297382
rizikem1270255401213357101125173223307
jedna1598255401212475133190239
třetina1857255401213366117152176232281
pacientů21582554012157107152176228284318373
buď25512554012157114172
zemřela,2743255401214394179212263288337359
nebo31222554012155107165222
u33642554012155
pacientů34392554012157107152176228284318373
nedošlo3402694012155107165221261286342
k7022694012147
dostatečnému7692694012156112152187237270321367423475559615
zlepšení1404269401214267118176216268324348
kvality1772269401214799149173197231282
života2074269401214367116171205255
či2349269401214468
symptomů.2437269401214089174232266321405461482
Futilita29392694012149102136160185209243292
TAVI32512694012150106158184
tak3455269401213382130
vede3605269401214898156208
ke340283401214797
zbytečnému4612834012143101148185236282338390474530
vystavení10152834012148100140175225273323379404
pacientů14422834012157107153177228285318374
riziku.1840283401213257101125173229251
K21152834012154
faktorům,2193283401212979127164219253309393415
které2632283401214784134168219
vedou2875283401214898156212269
ke3168283401214796
špatným3288283401214097147181237284369
výsledkům3681283401214899340297401214064115174221278362
po7222974012157114
TAVI8572974012150105158183
a10612974012148
zvyšují1130297401214395146187242267291
riziko1442297401213357101126173228
úmrtí16912974012155139173210234
navzdory19452974012156105152198256312346397
úspěšné2363297401215595153205245301353
implantaci,27362974012124108166191240296329379425449470
patří32272974012157107140174198
křehkost3446297401214782132189237292332367
pacientů3403114012156106151174225281314369
a7283114012148
některá7953114012156106154190240273322
kardiální1136311401214796129186210258282337361
i15163114012124
nekardiální15593114012155106153203236292316364388444467
onemocnění.20463114012154110161245300346402453508532553
Tyto2619311401214991127182
komorbidity28203114012147101184240273331355412436469519
tak3359311401213382129
mohou35073114012183138195250306
bránit340325401215791140197221255
zlepšení625325401214368119177217269325350
symptomů1005325401213989174232266321405461
a14963254012148
kvality1575325401214799148173197231282
života,1887325401214367116171205255277
na21943254012156105
druhou2329325401215790147203259315
stranu2675325401213974108157214269
některé29743254012156107155192243277327
mohou33323254012183139196252309
být36713254012157104141
po3403394012157114
implantaci4743394012123107165190239295328378424448
TAVI9423394012149105157183
reverzibilní.1145339401213383132182216261286343368392448472494
Článek1659339401215882131187238286
podává19653394012157114172221269318
přehled2303339401215791142198223274332
hlavních2655339401215680129176234258303359
přidružených3034339401215791115173206263307357414460505561
onemocnění,361533940121551121633403534012183139185241292348371393
která752353401214783133167216
se987353401214091
mohou10973534012183139195251307
podílet14233534012157113171195221272306
na17493534012155103
špatných1872353401213996146179235281325381
výsledcích,22723534012148100140164215273318342387443464
identifikaci2755353401212481132188221245275302349399444468
reverzibilních3242353401213383131181215260284341366390445469514570
faktorů340367401212978125162216249305
a6643674012148
pohled7323674012156112168192243301
na10523674012155103
hodnocení11753674012155110168223279325374430454
křehkosti,1648367401214681131187234288328362386407
která2074367401214783133166215
má23083674012183132
zásadní2459367401214293132181238294318
význam2796367401214899144200248332
pro3147367401215690145
futilitu3311367401212985119142166190223278
TAVI.36093674012149104156181203
Současně3403814012149104160205254294349400
poukazuje7593814012157113168215265309364388439
na12173814012155104
nutnost13403814012155110144199255294329
systematického1688381401213988128162212295344377400445492541597653
přístupu2360381401215790114153188243300356
k27353814012146
hodnocení28013814012155110168223279324374430453
pacientů,32743814012156105150174225280313368390
tak3683381401213382129
aby3403954012148106153
bylo5163954012157105130186
možné7253954012184140183240291
přesněji1039395401215791142182238289314338
a14013954012148
komplexněji14723954012147102186244269320369426477502526
posoudit20213954012157114154210267324348383
potenciální24273954012157114147198254300324373398454478
marnost29283954012183132166223279319354
TAVI.33053954012150106158184206
Klíčová340412001246190118163221273326
slova:687412001244472130182235261
transkatétrová969412401213366114169208255304337386420452507554602
implantace15934124012124107164188236291323372417466
aortální20814124012148103136172221244299322
chlopně,24254124012145100124179236292342362
aortální28094124012148103136172221244299322
stenóza,3153412401214074123179234276326347
futilita,3522412401212985118141164187220269290
křehkost,340426401214781131186233287326360381
stratifikace742426401214074106155187210240266312362407456
rizika.121942640121325699122169218239
TAVI:3404540012455115175204230
when5914540012476135188248
not8594540012459117154
anymore?10334540012453112163250309347401442
Transcatheter340471401215076125180218262310342396445478526558
aortic9244714012148102134169191234
valve1184471401214896118165214
implantation14244714012123105161184231285316364396418472526
(TAVI)1976471401212980134184208234
has22364714012155102140
caused2402471401214593146185234290
a27184714012149
significant2792471401214062117171193222247291338393424
change3242471401214599146200255304
in3572471401212478
the3676471401213387136
treatment340485401213363111156187267316369399
of754485401215481
aortic8504854012147100131165186228
stenosis.1093485401213971118171224261282319338
It1446485401212455
has15154854012155101138
expanded1667485401215095150196249303351406
treatment2088485401213263110156187267315369399
to2502485401213284
include2601485401212375118139192246294
patients29104854012156102133154202255286324
not32494854012154107138
previously3402485401215686134179201254307344365411
indicated340499401212376130152195241272319374
for729499401212982113
surgical856499401214092122176197240287308
intervention.1179499401212376107154185234281334365386439493512
Despite17064994012165114152206228259306
the2027499401213386134
tremendous2176499401213263111192240294348401454491
benefit26824994012156105159207235259291
of2987499401215582
this3084499401213285107144
method,32434994012182130162215268323342
there3600499401213285134165212
are340513401214879128
patients4835134012157104136157206260291331
who8295134012174128182
do10265134012157110
not11525134012155109140
benefit13085134012157106161210238263295
from1618513401212962115197
treatment1831513401213364112159190272321375406
and22535134012148102157
in2426513401212377
whom25185134012174128182264
TAVI27985134012149102152176
is2989513401212461
considered3066513401214597151189211266315346395451
unnecessary.35325134012155109163212256340527401215089127175206256271
In633527401212478
pivotal733527401215779127180211259282
studies1036527401214073127183205254292
of1350527401215583
high-risk1455527401215678132187218251273311357
patients,18345274012157104136158207262293333353
one-third22095274012155109159191223278300331386
either2617527401215073105159208240
died,2879527401215679128184204
or3105527401215486
their3213527401213387137159191
quality34265274012156110157179201233282
of3730527401215583
life34054140121244674123
failed480541401213077100122171227
to725541401213386
improve8285414012123105161193246293341
and11865414012148102158
their1361541401213387137159191
symptoms1569541401213986170225257311393431
persisted.20175414012157107139179200239271320376396
The24305414012150105155
futility2602541401212984116138160182214263
of2882541401215583
TAVI29825414012150104154178
in3177541401212377
such3271541401214093137192
patients34805414012157104136158207262293333
thus340555401213387141179
leads545555401212473120176214
to785555401213386
their897555401213387137159191
unnecessary11135554012156110164213258306345383431462512
exposure1651555401215096152207245299330379
to2056555401213386
risk.216855540121335593139161
Factors2355555401214892136170223255294
that2675555401213387134166
lead2867555401212373120175
to3068555401213386
poor31805554012157112167199
outcomes34055554012155109141184236319369407
after340569401214876111159191
TAVI5475694012149103153176
and7395694012148102158
increase912569401212478121153201248286335
the1263569401213387136
risk141556940121335593138
of1569569401215583
death16685694012156105152183237
despite19215694012156105143199221253301
successful2238569401213993136179227265303332387409
implantation26635694012123105160183230284315363394416470524
include3203569401212377121143196252301
patient35205694012157104135157206261292
frailty340583401212962109131154186234
and5945834012148103158
certain772583401214593125159207229284
cardiac1075583401214593124179202248292
and13875834012148102158
non-cardiac15655834012155109164195242289321376398445489
diseases.2074583401215678116166213251300339359
These24535834012150105154193242
comorbidities2715583401214597180234266322345401423455477526564
may32995834012184131175
prevent3494583401215789138184232287318
improvement3405974012123105161193247293341423473528559
in918597401212478
symptoms1015597401214087170226258311394432
and14665974012149103158
quality16445974012156110157179201233282
of1946597401215583
life.204859740121244674123142
On22105974012169124
the2353597401213388137
other2509597401215587141191223
hand,27515974012155102157212232
some3002597401214094177226
comorbidities3248597401214597180234266322345400423455477526564
may3406114012184131177
be5436114012157108
reversible677611401213383130178210250272328352401
after1105611401214977113161194
the1325611401213388138
TAVI14906114012150104154178
procedure.1695611401215790144189237294348380429449
This21706114012150106128167
article2363611401214981116138182205255
provides2644611401215890144190214270319358
an30296114012148103
overview31596114012155102150182233256306379
of3564611401215584
the3674611401213488138
main3406254012185134157213
associated580625401215089128184230253302334384442
comorbidities10506254012146100185241274332355412436469492543582
that1660625401213490138171
may18586254012186134180
contribute20666254012146100156189222245302358392442
to2535625401213489
poor26516254012158115171205
outcomes,28836254012156112146190244329380420441
identifying3351625401212482132189221244274325349405462
reversible340639401213382128176208247269325348397
factors757639401212977121155208240279
and10566394012148102158
looking1234639401212377132178202256311
at1565639401214880
frailty1664639401212962109131154186234
assessment.1918639401214886124174212250332382437468488
The24266394012149105154
latter2600639401212370102136184216
is2836639401212361
crucial2917639401214576130174196243266
for3202639401212983115
TAVI33376394012150103154177
futility.3534639401212984116138160182214263278
The3406534012150105155
paper5126534012157104160210242
also771653401214971109163
highlights952653401215577132186209231286340371411
the1380653401213387137
need15346534012156105155211
for1763653401212983115
a18956534012148
systematic1960653401214087126159207290337368390434
approach24116534012148104160192246294337391
to2820653401213386
patient29236534012157105136158207262293
assessment3234653401214886124174212250332382436468
so3719653401214094
that340667401213385131161
the516667401213285133
potential6636674012156109140187240270291337358
futility1036667401212882113134155176207254
of1305667401215481
TAVI14006674012149101150173
could1587667401214495148170223
be18256674012156104
assessed1944667401214784121169206243291346
more23046674012182135166213
accurately2531667401214890131184214260290337359404
and29506674012147100154
comprehensively.3118667401214496176230261308362410463500520566613635680695
Key3406840012462114166
words:5346840012476134173234279305
transcatheter868684401213366115171211257306339395446479529563
aortic14596844012149105138174198243
valve1731684401214897121170220
implantation,19796844012124108165190238294327376409433488545566
aortic25746844012148104137173197242
stenosis,2845684401214074124180236276299339360
futility,3234684401212986119143166190223274290
frailty,3553684401212963112136159193243260
risk34069840121335695142
stratification.503698401214074106155187210240266311359392415470526547
Úvod3407450014780142208279
Jediná480762101093379131152202246
léčba,745762101092267109160204224
která988762101094275120150194
zlepšuje1201762101093960106158193243264310
přežití1530762101095282127166187217239
a17887621010943
kvalitu185176210109428813234077610109214272122
života484776101093860104153182227
u7327761010950
pacientů804776101095195136157203253283332
s11587761010936
těžkou1215776101093075114156205255
symptomatickou14927761010936791552072372863624054354564972140748101094290139
aortální2294748101094392122154197218268288
stenózou2598748101093565109159208245294343
(AS)2957748101092579124148
je3120748101092267
náhrada3202748101095093142171214265308
aortální3525748101094392121153197218267288
chlopně2140762101094191113163215266312
(1,247876210109266883
2).258776210109467088
Až2700762101095697
donedávna28237621010951101152199251295338389433
však3282762101094379124167
nejméně3475762101095096118194240291337
jedna2140776101092268119170213
třetina2373776101093059104135156206250
těchto2642776101093075116166196245
pacientů2906776101095296137158203254283333
nepodstoupila3259776101095095147198250285316365415467488510553
DECLARATIONS:4070199708648871301662142563043393604124625014571199808514
Ethical406921340873764107127160198219
principles43022134087427090132165185229249288319
compliance:463621340873172134177198218256298331369388
The406922460853678116
authors420622460853475100142183208238
attest44652246085356087124154179
that466522460852465101126
their481222460852465103121146
study49792246085295596138173
was517422460855389118
approved531422460853477119144185220257300
by406923560854073
the41592356085236399
local42752356085165689124141
Ethical44332356085345898115147182199
Committee464923560854179139198215239265300337
and500223560853474114
is513323560851745
in519523560851656
compliance526723560853270130170188205239279311347
with40692466085537298139
human423624660854082143180222
studies44862466085285596139157195226
and474024660853476119
animal48872466085347695157193212
welfare512724660855391110133170195233
regulations53882466085246110414616420140692576085234080120148
of423725760853859
the43162576085236399
authors’44352576085347397136176200229244
institutions46992576085165684109126150189214231270310338
as505725760853462
well513925760855187105122
as528125760853362
with53622576085526994133
the55152576085236399
World406926860856099124142184
Medical427426860855795137154188224242
Association453626860854474104144178196231256273314355
Declaration491226860854785119136172196232257274315356
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