主动脉瓣疾病手术治疗现状与进展  

Current status and progress of aortic valve surgery treatment

作　　者：王世杰 刘鹏[1] 温姝钰 王寅 乔韡华 董念国[1] WANG Shijie;LIU Peng;WEN Shuyu;WANG Yin;QIAO Weihua;DONG Nianguo(Department of Cardiovascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院心脏大血管外科,武汉430022

出　　处：《临床心血管病杂志》2023年第6期417-424,共8页Journal of Clinical Cardiology

摘　　要：主动脉瓣疾病的人群患病率稳中有升,迄今为止手术治疗是其最为有效的治疗手段。外科主动瓣膜置换、经导管主动脉瓣置换、主动脉瓣修复是手术治疗方案的3大策略。经典的开放式外科主动脉瓣瓣膜置换提供了最为稳定有效的治疗效果。经导管主动脉瓣置换则以其近乎无创、高临床获益的特点给老年全风险人群新的治疗选择。而主动脉瓣修复则以天然无植入、更高的生活质量以及可能更长的耐久性吸引了年轻的心脏瓣膜病患者。随着对疾病机理认识的加深、材料和技术的不断进步,对于某一特定主动脉瓣疾病患者的外科处理有着更加多元化的选择,这就要求心脏外科医生根据患者情况结合现有最新证据为患者制定个体化治疗方案甚至瓣膜疾病终身管理策略。The prevalence of aortic valve disease is steadily increasing, and surgical treatment is the most effective treatment. Surgical active valve replacement(SAVR), transcatheter aortic valve replacement(TAVI), and aortic valve repair(AVP) are the three strategies of surgical treatment. Classical open SAVR provides the most stable and effective therapeutic effect. TAVR is a new treatment option for elderly patients with its characteristics of near-non-invasive and high clinical benefits, while AVP attracts young patients due to the natural valve reserve, higher living quality and possibly longer durability. With the deepening of the understanding of the disease mechanism and the continuous progress of materials and technology, there are more diversified options for patients with a specific aortic valve disease, which requires cardiac surgeons to develop individualized treatment plans or even lifelong management strategies for patients according to the patient's condition combined with the latest evidence.

关 键 词：主动脉瓣疾病 外科主动脉瓣置换术 经导管主动脉瓣置换术 主动脉瓣修复术 

分 类 号：R541.3[医药卫生—心血管疾病]