经导管瓣中瓣技术在二尖瓣生物瓣衰败中应用的临床现状  

Clinical status of transcatheter valve-in-valve replacement in the treatment of mitral bioprosthetic valve failure

作　　者：车波 宋丹 徐承义 CHE Bo;SONG Dan;XU Cheng-yi(Medical College of Wuhan University of Science and Technology,Wuhan 430081,China;Department of Cardiology,Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430022,China)

机构地区：[1]武汉科技大学医学院,湖北省武汉市430081 [2]武汉科技大学附属武汉亚洲心脏病医院心内科

出　　处：《中国心血管病研究》2022年第5期476-480,共5页Chinese Journal of Cardiovascular Research

摘　　要：人工瓣膜置换术是替代病理性天然瓣膜的金标准。目前使用生物瓣膜的比例在不断升高,但生物瓣膜会随时间的推移及各种因素影响导致生物瓣衰败,使其长期的耐久性有限,即结构性瓣膜退化。通常患者需要再次行瓣膜置换术,而传统外科开胸手术创伤大,患者常因不能耐受而放弃外科手术治疗。经导管瓣中瓣技术治疗二尖瓣生物瓣衰败(TMViVR)作为再次外科开胸瓣膜置换手术的替代治疗方案,安全、可靠,且能够快速缓解患者的症状,提高生活质量和预期寿命。尽管目前仍面临较多挑战,包括左心室流出道梗阻、生物瓣膜不匹配、缺乏瓣膜长期耐久性的随访数据等,但随着这项技术的持续进步,其安全性和可行性已被逐步证实。本文旨在对TMViVR术实施要点、临床研究现状以及对未来的发展进行综述。Artificial valve replacement is a gold standard treatment to the replace pathological native valve.At present,the proportion of using bioprosthetic valve is increasing,but bioprosthetic valve will experience bioprosthetic valve failure over time and the influence of various factors,so that its long-term durability is limited,that is,structural valve degeneration.Usually,patients need to undergo valve replacement again,but the traditional thoracotomy is traumatic,and the patients often give up surgical treatment because they can not tolerate it.Transcatheter mitral valve-in-valve replacement(TMViVR),as an alternative treatment,provides a safe and reliable option for the reoperation which can quickly relieve patients’symptoms and improve their quality of life and life expectancy.Although there are still many challenges,including left ventricular outflow tract obstruction,bioprosthetic valve mismatch,lack of follow-up data on valve long-term durability,its feasibility and safety have been proved with the gradual progress of this technique.This paper focus on the implementation main point,clinical research status and future development of TMViVR.

关 键 词：经导管瓣膜置换 瓣中瓣 二尖瓣 生物瓣衰败 

分 类 号：R542.5[医药卫生—心血管疾病]