经导管主动脉瓣置换“瓣中瓣”的应用进展  

ADVANCES IN THE APPLICATION OF THE“VALVE-IN-VALVE”TECHNIQUE IN TRANSCATHETER AORTIC VALVE REPLACEMENT

作　　者：何宇 刘珂崎 张榕[1] 刘晓燕[1] 江磊[2] HE Yu;LIU Keqi;ZHANG Rong;LIU Xiaoyan;JIANG Lei(Department of Cardiothoratic Surgery,Ya′an People’s Hospital,Ya′an 625000,China)

机构地区：[1]雅安市人民医院心胸外科,四川雅安625000 [2]青岛大学附属医院心血管外科

出　　处：《精准医学杂志》2023年第3期276-278,282,共4页Journal of Precision Medicine

摘　　要：由于生物瓣膜的优点,国际上外科手术主动脉瓣换瓣使用生物瓣膜的越来越多。但由于生物瓣膜的耐久性差等原因导致的瓣膜衰败,是目前人工生物瓣膜不可避免的问题。病人一旦出现严重瓣膜衰败,可导致瓣膜狭窄或反流,引起心脏扩大及心功能不全,常需要再次置换瓣膜。很长一段时间以来外科手术换瓣为主动脉生物瓣膜衰败治疗的金标准。但目前生物瓣膜使用者多为老年病人,再次外科手术换瓣风险大,很多病人因此被拒绝于手术之外。近年由于经导管主动脉瓣植入术(TAVR)经验的积累和技术的进步,使其在生物瓣膜衰败治疗中的应用越来越多,特别是经导管主动脉“瓣中瓣”(VIV TAVR)的应用将改变这一局面。现将其应用综述如下。More and more biological valves have been used in aortic valve replacement in the world due to their unique advantages;however,due to the poor durability of biological valves and other reasons,valve deterioration is an inevitable problem of artificial biological valves.Once severe valve deterioration occurs,it can lead to valve stenosis or regurgitation,which may result in cardiac enlargement and cardiac insufficiency and often require valve re-replacement.Surgical valve replacement has long been the gold standard for the treatment of aortic valve deterioration,but since biological valves are mostly used in the elderly and there is a high risk of surgical valve re-replacement,many patients are rejected from surgery.In recent years,due to the accumulation of experience in transcatheter aortic valve replacement(TAVR)and related technical advances,it has been increasingly applied in the treatment of biological valve deterioration,especially the application of“valve-in-valve”TAVR.

关 键 词：心脏瓣膜 人工 主动脉瓣 瓣中瓣 生物瓣 综述 

分 类 号：R654.27[医药卫生—外科学]