经导管主动脉瓣植入术相关冠状动脉阻塞的研究进展  

Research progress of coronary artery occlusion associated with transcatheter aortic valve implantation

作　　者：杜招娜 芦秀燕 邵一兵[2] 夏伟[2] DU Zhaona;LU Xiuyan;SHAO Yibing;XIA Wei(School of Clinical Medicine,Weifang Medical University,Weifang,261000,Shandong,P.R.China;First Department of Cardiology,Qingdao Municipal Hospital East Hospital,Qingdao Hospital,University of Health and Rehabilitation Sciences,,Qingdao,266000,Shandong,P.R.China)

机构地区：[1]潍坊医学院临床医学院潍坊医学院,山东潍坊261000 [2]康复大学青岛医院青岛市市立医院东院区心内一科,山东青岛266000

出　　处：《中国胸心血管外科临床杂志》2023年第8期1188-1192,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：2021年度青岛市医药卫生科研计划项目(2021-WJZD004)。

摘　　要：经导管主动脉瓣植入术已成为老年中、高危主动脉瓣狭窄患者的主要治疗手段。但与其相关的冠状动脉阻塞却是极为严重的并发症,常产生不良预后,因此积极的术前预防尤为重要。术前计算机断层扫描评估、生物假体主动脉瓣扇形撕裂技术及烟囱支架植入技术等可预防经导管主动脉瓣植入术相关的冠状动脉口受阻。术中保证对合缘对齐可减少冠状动脉阻塞的发生,但其远期预后有待进一步研究。此外,经皮冠状动脉介入干预是其主要的治疗方式,但存在瓣膜植入术后冠状动脉入路困难等问题。本文总结了经导管主动脉瓣植入术相关冠状动脉阻塞的发生机制、预防措施及治疗方式等方面的研究进展。Transcatheter aortic valve implantation(TAVI)has become the main treatment for elderly patients with middle and high risk aortic stenosis.However,coronary artery occlusion(CAO)related to TAVI is a very serious complication,which often leads to poor prognosis.Therefore,active preoperative prevention is particularly important.Preoperative computed tomography evaluation,bioprosthetic or native aortic scallop intentional laceration and chimney stent implantation technology can prevent TAVI-related coronary orifice obstruction.Ensuring commissural alignment during operation can reduce the occurrence of coronary occlusion,but its long-term prognosis needs further study.In addition,percutaneous coronary intervention is the main treatment,but there are problems such as difficult coronary access after TAVI.This article summarized the research progress in the mechanism,prevention and treatment of CAO related to TAVI.

关 键 词：经导管主动脉瓣植入术 冠状动脉阻塞 预防 治疗 综述 

分 类 号：R654.2[医药卫生—外科学]