自膨式Venus-A瓣膜和VitaFlow瓣膜治疗重度主动脉瓣狭窄的临床效果  

Self-expanding Venus-A valve versus VitaFlow valve in the treatment of severe aortic stenosis:analysis of clinical effect

作　　者：邢利菲 韩宇 刘煜昊 王圣 葛英辉 刘琳 张戈军[5] XING Lifei;HAN Yu;LIU Yuhao;WANG Sheng;GE Yinghui;LIU Lin;ZHANG Gejun(Department of Radiology,People’s Hospital of Zhengzhou University(Henan Provincial People’s Hospital,Central China Fuwai Hospital),Zhengzhou,Henan Province 450003,China)

机构地区：[1]郑州大学人民医院(河南省人民医院、华中阜外医院)放射科,450003 [2]郑州大学人民医院(河南省人民医院、华中阜外医院)结构性心脏病区 [3]郑州大学人民医院(河南省人民医院、华中阜外医院)心外科 [4]郑州大学人民医院(河南省人民医院、华中阜外医院)超声科 [5]中国医学科学院北京协和医学院阜外医院国家心血管病中心结构性心脏病中心

出　　处：《介入放射学杂志》2022年第8期756-760,共5页Journal of Interventional Radiology

基　　金：河南省中青年卫生健康科技创新人才培养项目(YXKC2020047)。

摘　　要：目的 对比两种国产经导管自膨式主动脉瓣膜置换系统Venus-A、VitaFlow治疗重度主动脉瓣狭窄(AS)的临床效果。方法 回性顾分析2018年3月至2021年7月华中阜外医院采用一代Venus-A瓣膜/VitaFlow瓣膜行经导管主动脉瓣置换术(TAVR)治疗的79例重度AS患者临床资料,其中Venus-A组54例,VitaFlow组25例。比较两组患者手术结果和1年随访结果。结果 Venus-A组、VitaFlow组瓣膜植入成功率分别为100%、96%,但差异无统计学意义(P=0.316)。VitaFlow组与Venus-A组相比球囊预扩张比例较低(88%比100%)、后扩张比例较高(12%比0)(均P<0.05)。两组患者TAVR术后血流动力学指标与术前相比显著改善,术后1年Venus-A组中量及以上瓣周漏发生较VitaFlow组少(5.8%比4.2%),但差异无统计学意义(P>0.05)。两组术后脑卒中、严重血管并发症发生率及永久起搏器植入率低(P>0.05)。Venus-A组、VitaFlow组术后30 d无死亡病例,术后1年全因死亡率分别为3.7%、0(P>0.05)。结论 虽然两种自膨胀瓣膜在TAVR治疗重度AS患者术中行球囊预扩张和后扩张比例有差异,但术后近期效果均良好。Objective To compare the clinical effect of two domestic transcatheter self-expanding aortic valve replacement systems, i.e. Venus-A valve and VitaFlow valve, in treating severe aortic stenosis(AS).Methods The clinical data of 79 patients with AS, who received transcatheter aortic valve replacement(TAVR) by using the first-generation Venus-A valve or VitaFlow valve at the Central China Fuwai Hospital of China between March 2018 and July 2021, were retrospectively analyzed. Venus-A valve was adopted in 54 patients(Venus-A group) and VitaFlow valve was employed in 25 patients(VitaFlow group). The therapeutic outcomes and one-year follow-up results were compared between the two groups. Results The success rates of valve implantation in Venus-A group and VitaFlow group were 100.0% and 96.0% respectively(P=0.316).The proportion of balloon pre-dilation in VitaFlow group was 88.0%, which was lower than 100.0% in Venus-A group(P<0.05), while the proportion of balloon post-dilation in VitaFlow group was 12.0%, which was higher than 0.0% in Venus-A group(P<0.05). After TAVR, in both groups the hemodynamic indexes were significantly improvement when compared with preoperative ones. One year after TAVR, the incidence of medium and large perivalve leakage in Venus-A group was lower than that in VitaFlow group(5.8% versus 4.2%, P>0.05). The postoperative incidences of stroke, severe vascular complications, and the implantation rate of permanent pacemaker were very low in both groups, and no statistically significant difference existed between the two groups(P>0.05). No death occurred in both groups within 30 days after TAVR, and the postoperative one-year all-cause mortality in Venus-A group and VitaFlow group was 3.7% and 0% respectively(P>0.05). Conclusion In treating severe AS by using TAVR, both Venus-A valve and VitaFlow valve have good short-term clinical effect, although the differences in the proportion of balloon pre-dilation and balloon post-dilation between the two groups are significantly different.

关 键 词：主动脉瓣狭窄 经导管主动脉瓣膜置换术 Venus-A瓣膜 VitaFlow瓣膜 

分 类 号：R654.2[医药卫生—外科学]