单中心二叶式主动脉瓣经导管主动脉瓣置换术前多层螺旋CT评估  

Multidetector CT characteristics of bicuspid aortic valve before transcatheter aortic valve replacement in single center

作　　者：朱嘉俊[1] 赵倩[1] 杨毅宁[1] ZHU Jiajun;ZHAO Qian;YANG Yining(Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,P.R.China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054

出　　处：《华西医学》2020年第9期1050-1054,共5页West China Medical Journal

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究(2018YFC1312804)。

摘　　要：目的研究多层螺旋CT(multidetector CT,MDCT)在经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)治疗主动脉瓣狭窄(aortic stenosis,AS)中二叶式主动脉瓣术前评估结果,总结相关经验。方法连续入选2016年3月—2020年6月在新疆医科大学第一附属医院心脏中心行TAVR治疗的AS患者33例,对二叶式主动脉瓣与三叶式主动脉瓣术前MDCT的评估进行比较。结果33例AS患者中男22例,女11例;平均年龄(74±6)岁;二叶式主动脉瓣患者17例,三叶式主动脉瓣患者16例;钙化积分的中位数(下四分位数,上四分位数)为360(192,1034)mm^3。术前评估预判人工瓣膜需下调瓣膜大小12例,其中二叶式主动脉瓣合并钙化为9例(75%)。结论二叶式主动脉瓣合并钙化时TAVR治疗下调瓣膜大小比率较高。Objective To explore the preoperative evaluation result of multidetector computed tomography(MDCT)in aortic stenosis(AS)patients with bicuspid aortic valve(BAV)undergoing transcatheter aortic valve replacement(TAVR)in order to summarize relevant experience.Methods A total of 33 consecutive AS patients who underwent TAVR in Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University from March 2016 to June 2020 were enrolled,and the preoperative evaluation characteristics of MDCT were compared between tricuspid aortic valve(TAV)and BAV.Results In the 33 patients,whose mean age was(74±6)years,22 were male and 11 were female,17 were with BAV and 16 were with TAV.The medium(lower quartile,upper quartile)of calcification score was360(192,1034)mm^3.There were 12 cases of artificial valve model to be speculated Downsize,including 9 calcific BAV cases(75%).Conclusion The calcific BAV has a higher ratio of Downsize in the TAVR procedure.

关 键 词：经导管主动脉瓣置换术 二叶式主动脉瓣 三叶式主动脉瓣 多层螺旋CT 

分 类 号：R654.2[医药卫生—外科学]