经股动脉经导管主动脉瓣置换术治疗单纯主动脉瓣反流的研究进展  

Clinical advances of transfemoral transcatheter aortic valve replacement in the treatment of pure aortic valve regurgitation

作　　者：车波 徐承义[1] 徐文杰 鄢华[1] 宋丹[1] CHE Bo;XU Cheng-yi;XU Wen-jie;YAN Hua;SONG Da(Department of Cardiology,Wuhan Asia Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院心内科,湖北武汉430022

出　　处：《中国介入心脏病学杂志》2023年第3期225-230,共6页Chinese Journal of Interventional Cardiology

摘　　要：经导管主动脉瓣置换术(TAVR)已成为国内外指南推荐治疗老年主动脉瓣狭窄(AS)的一线治疗方案,也适用于AS合并不同严重程度主动脉瓣反流的患者,但在单纯主动脉瓣反流(PAR)中却不做常规推荐,传统外科主动脉瓣置换术仍然是治疗PAR的金标准。外科手术禁忌或高危PAR患者,常放弃外科手术治疗,选择保守治疗,而后者的死亡率更高。经股动脉TAVR(TF-TAVR)为其提供了一种替代治疗方案,尽管仍面临手术技术要求高、缺乏针对PAR的瓣膜系统和术后长期随访数据等挑战,但随着TAVR技术经验积累、新一代瓣膜系统的发展及长期随访数据的反馈,TF-TAVR治疗PAR逐渐被证实是一种安全、可行的外科手术替代治疗方式,本文对TF-TAVR治疗PAR实施要点、临床研究现状以及未来的发展进行综述。Transcatheter aortic valve replacement,the fi rst-line treatment for elderly patients with aortic stenosis(AS)by guideline recommended,is suitable to AS patients with diff erent severity of aortic regurgitation.However,it is not routinely recommended in pure aortic regurgitation(PAR),and the traditional surgical aortic valve replacement remains the gold standard for the treatment of PAR.Patients often give up surgical treatment in favor of conservative treatment for surgically contraindicated or high-risk PAR patients,which is associated with higher mortality.Transfemoral transcatheter aortic valve replacement(TF-TAVR)provides an alternative treatment.Despite the high surgical requirements,lack of valve system for PAR and long-term follow-up data.TF-TAVR has been gradually proved to be a safe and feasible surgical alternative treatment for PAR,with the accumulation of TAVR technology experience,the development of new generation of valve system and the feedback of long-term follow-up data.This paper focus on the implementation main points,clinical research status and future development of TF-TAVR for PAR.

关 键 词：经导管主动脉瓣置换术 经股动脉 单纯主动脉瓣反流 经导管心脏瓣膜 主动脉瓣狭窄 

分 类 号：R542.5[医药卫生—心血管疾病]