单纯超声心动图技术指导经皮二尖瓣缘对缘修复术的可行性探索  

Feasibility Exploration of Transesophageal Mitral Valve Edge-to-edge Repair Under Transesophageal Echocardiographic Guidance Solely

作　　者：冯舒毅 段福建 张凤文 王首正 孔朋旭 李泽夫 李文超 魏培坚 房芳 潘湘斌 FENG Shuyi;DUAN Fujian;ZHANG Fengwen;WANG Shouzheng;KONG Pengxu;LI Zefu;LI Wenchao;WEI Peijian;FANG Fang;PAN Xiangbin(Department of Structural Heart Disease,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Ultrasound Imaging Center,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Pediatric Cardiac Surgery,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Fuwai Central China Cardiovascular hospital,Zhengzhou 451464,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、结构性心脏病中心,北京100037 [2]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、超声影像中心,北京100037 [3]郑州大学人民医院、河南省人民医院心脏中心、阜外华中心血管医院、儿童心脏病中心,郑州451464

出　　处：《中国循环杂志》2023年第8期815-819,共5页Chinese Circulation Journal

基　　金：中央级公益性科研院所基本科研业务费(2019PT350005);国家自然科学基金(81970444);北京市科技计划(Z201100005420030);国家高层次人才特殊支持计划(2020-RSW02)。

摘　　要：目的:探讨单纯经食道超声心动图引导经皮二尖瓣缘对缘修复术的安全性及有效性。方法:连续纳入2021年4~6月在中国医学科学院阜外医院行单纯经食道超声心动图引导经皮二尖瓣缘对缘修复术治疗的10例中重度至重度二尖瓣反流患者,并于术后1个月及6个月进行了随访。二尖瓣反流程度由超声核心实验室评估诊断(0+表示无/轻微反流,1+表示轻度反流,2+表示中度反流,3+表示中重度反流,4+表示重度反流)。结果:10例患者,平均年龄(69.4±6.7)岁,7例为男性;均在单纯经食道超声心动图引导下成功行经皮二尖瓣缘对缘修复术,并均置入了1枚夹子。术后6个月时,所有患者二尖瓣反流程度较术前明显减轻,8例患者二尖瓣反流程度≤1+,9例患者二尖瓣反流程度≤2+;与术前相比患者心功能显著提升,NYHA心功能分级Ⅰ~Ⅱ级的患者由术前的1例增加到9例。结论:单纯经食道超声心动图引导下行经皮二尖瓣缘对缘修复术可行,且安全有效。Objectives:To investigate the safety and efficacy of operating transcatheter mitral valve edge-to-edge repair(TEER)under transesophageal echocardiographic guidance solely.Methods:Between April 2021 and June 2021,10 patients with moderate-severe or severe mitral regurgitation(MR)underwent TEER under transesophageal echocardiographic guidance solely were enrolled.Follow-up including echocardiography and clinical evaluation were performed at baseline,1 month,and 6 months after procedure.Results:All 10 patients(7 male,mean age[69.4±6.7]years)underwent successful TEER under transesophageal echocardiographic guidance solely,and all patients implanted 1 clip.At 6-month follow-up,80%of patients had MR≤1+and 90%had MR≤2+.The cardiac function of patients was significantly improved after procedure,and the number of patients with NYHA functional classⅠ-Ⅱincreased to 9.Conclusions:Transcatheter mitral valve edge-to-edge repair under transesophageal echocardiography guidance solely is feasible and safe.

关 键 词：二尖瓣反流 经导管治疗 超声心动图 二尖瓣修复术 

分 类 号：R54[医药卫生—心血管疾病]