超声心动图在经导管主动脉瓣置换术引发的急性冠状动脉闭塞预防与诊断中的应用进展  

Application of echocardiography in the prevention and diagnosis of acute coronary occlusion after transcatheter aortic valve replacement

作　　者：严琪琦 张健[3] 叶利方 吴刘洋 徐蕴异 王利宏[2] YAN Qiqi;ZHANG Jian;YE Lifang;WU Liuyang;XU Yunyi;WANG Lihong(The Second Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]浙江中医药大学第二临床医学院,杭州310053 [2]浙江省人民医院心内科 [3]浙江省人民医院超声科

出　　处：《心电与循环》2021年第6期565-569,共5页Journal of Electrocardiology and Circulation

摘　　要：大量证据表明,利用经导管主动脉瓣置换术(TAVR)治疗重度主动脉狭窄(AS)的效果与外科主动脉瓣置换术相当。随着TAVR的适应证转向低风险甚至无症状患者,TAVR围术期并发症必然成为医疗团队关注的热点问题。急性冠状动脉闭塞(ACO)是其罕见但致死率极高的并发症之一,直接关乎TAVR的成败。超声心动图是TAVR术前、术中及术后最常用的影像学检查手段之一,具有实时监测、无对比剂、零辐射等优势,在术前评估ACO危险因素以及术中、术后精准监测和及早识别中具有重要作用。本文对超声心动图在TAVR引发的ACO预防与诊断中的应用进展作一述评,以期为TAVR手术团队提供参考。A large number of evidence has shown that the effect of transcatheter aortic valve replacement(TAVR)in the treatment of severe aortic stenosis(AS)is equivalent to that of surgical aortic valve replacement.With the indication of TAVR shifting to low-risk,even asymptomatic patients,the complications of TAVR must be the focus of the medical team.Acute coronary occlusion(ACO)is one of the rare but fatal complications of TAVR,which is directly related to the success of TAVR procedure.Echocardiography,as one of the most commonly used imaging methods in TAVR,plays an important role in evaluating the risk factors of ACO before operation,monitoring and early identification of ACO during and after operation.Moreover,echocardiography has the advantages of real-time monitoring,no contrast agent,zero radiation and etc.In order to help the TAVR team better understand the application of echocardiography in prevention and early diagnosis of ACO,this review summarizes the progress of echocardiography application in TAVR.

关 键 词：经导管主动脉瓣置换术 超声心动图 急性冠状动脉闭塞 主动脉狭窄 

分 类 号：R654.2[医药卫生—外科学] R543.3[医药卫生—临床医学]