使用球囊扩张瓣膜经皮主动脉瓣置换术后亚临床血栓现象的初步分析  

Preliminary analysis of subclinical leaflet thrombosis after percutaneous aortic valve replacement with balloon dilation

作　　者：李易航 张靖男 房芳 万俊义 徐亮[1] 潘湘斌[1] 张戈军[1] LI Yihang;ZHANG Jingnan;FANG Fang;WAN Junyi;XU Liang;PAN Xiangbin;ZHANG Gejun(Department of Cardiology,National Center for Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100021,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院、国家心血管病中心、阜外医院、心内科,北京100021

出　　处：《中国胸心血管外科临床杂志》2023年第3期410-415,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析使用球囊扩张瓣膜(Sapien3,S3)行经皮主动脉瓣置换术后亚临床血栓(subclinical leaflet thrombosis,SLT)现象的影响因素。方法回顾性分析2020年9月—2022年6月在中国医学科学院阜外医院使用S3行经皮主动脉瓣置换术62例重度主动脉瓣狭窄患者的临床资料。选取既往有血管粥样硬化病史或术后随访主动脉瓣流速/压差明显升高或下降不明显患者进行CT检查。结果最终纳入26例患者,平均年龄(70.31±8.90)岁,男性占比更大(n=15,57.69%)。其中5例检出SLT,相对于非SLT组,SLT组年龄偏大[(68.52±8.80)岁vs.(77.80±4.66)岁,P=0.007]。年龄因素(≥75岁)、升主动脉内径与SLT发生有相关性(P均<0.05)。结论高龄患者SLT发生率更高,推测SLT发生与球囊扩张瓣膜短、瓣架低血流动力学等特点有关。Objective To analyze the factors influencing the occurrence of subclinical leaflet thrombosis(SLT after percutaneous aortic valve replacement using balloon-expandable valve(Sapien3,S3).Methods Retrospective analysis was made on 62 patients with severe aortic stenosis undergoing percutaneous aortic valve replacement using S3 in our center from September 2020 to June 2022.Patients with a history of vascular atherosclerosis or with significant increase or insignificant decrease of aortic valve flow or gradient pressure during follow-up were selected for CT examination.Results A total of 26 patients were finally included,with an average age of 70.31±8.90 years,and the male proportion was higher(n=15,57.69%).Among them,5 patients had SLT.Compared with the non-SLT group,patients in the SLT group were older(68.52±8.80 years vs.77.80±4.66 years,P=0.007).The age factor(≥75 years)and the diameter of the ascending aorta were associated with SLT(both P<0.05).Conclusion The incidence of SLT is higher in the elderly patients.It is speculated that SLT is related to the characteristics of short balloon dilation valves and low blood flow dynamics of valve racks.

关 键 词：经皮主动脉瓣置换术 球囊扩张瓣膜 亚临床血栓 

分 类 号：R654.2[医药卫生—外科学]