重度主动脉瓣狭窄合并多瓣膜病变患者介入术对左心室结构与功能的影响  

Effect of transcatheter aortic valve implantation on left ventricular structure and function in patients with severe aortic stenosis complicated with multivalve disease

作　　者：葛小明[1] 翟光耀[2] 陈江[1] GE Xiaoming;ZHAI Guangyao;CHEN Jiang(Department of Cardiology,The First Hospital of Fangshan District,Beijing 102400,China)

机构地区：[1]北京市房山区第一医院心内科,102499 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科

出　　处：《心肺血管病杂志》2022年第4期369-374,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨单纯重度主动脉瓣狭窄(AS)与AS合并其他瓣膜疾病患者行经导管主动脉瓣置入术(TAVI)效果差异。方法:回顾性纳入2019年至2020年,于首都医科大学附属北京安贞医院行TAVI手术患者114例,将其分为单纯AS组及AS合并其他瓣膜疾病组,通过超声心动图数据,分别比较两组患者TAVI术前术后主动脉瓣功能及左心室结构和功能差异,并比较两组患者TAVI手术效果差异。结果:单纯AS组和AS合并其他瓣膜病变组均可观察到TAVI术后升主动脉窦内径、主动脉瓣上流速、跨主动脉瓣最大压差、LVEDD和LVEF明显改善。AS合并其他瓣膜疾病组左心房最大内径、室间隔厚度、左心室后壁厚度和LVESD较术前改善,合并中度及以上的二尖瓣反流比例减小。TAVI手术前后两组主动脉瓣功能和左心室结构功能改善无差异。结论:单纯AS与AS合并多瓣膜疾病患者术后主动脉瓣功能及左心室结构和功能改善明显,且改善在两组中无差异。Objective:To investigate the effect of transcatheter aortic valve implantation(TAVI)in patients with severe aortic stenosis(AS)and AS with multivalvular disease.Methods:A total of 114 patients who underwent TAVI surgery in Beijing Anzhen Hospital affiliated to Capital Medical University from 2019 to 2020 were retrospectively enrolled and divided into AS group and AS with multivalvular disease.The differences in aortic valve function and left ventricular structure and function before and after TAVI were compared between the two groups according to echocardiographic data.The results of TAVI were compared between the two groups.Results:The ascending aortic sinus diameter,upper aortic valve flow rate,maximum pressure difference across aortic valve,left ventricular end-diastolic diameter and left ventricular ejection fraction were significantly improved after TAVI in both AS group and AS with multivalvular disease.The maximum diameter of left atrial,thickness of interventricular septum,thickness of left ventricular posterior wall and diameter at the end of left ventricular contraction were improved in the AS with multivalvular disease group,while the proportion of mitral regurgitation with moderate or above decreased.There was no difference in the improvement of aortic valve function and left ventricular structure function between the two groups before and after TAVI.Conclusions:Postoperative aortic valve function and left ventricular structure and function were significantly improved in patients with AS alone and AS with multivalvular disease,and there was no difference in improvement between the two groups.

关 键 词：主动脉瓣狭窄 多瓣膜疾病 经导管主动脉瓣置入术 超声心动图 

分 类 号：R54[医药卫生—心血管疾病]