经导管球囊扩张式瓣膜在主动脉瓣狭窄中应用的初步经验  

Preliminary Experience of Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis with a Balloon-Expandable Valve

作　　者：孙英皓 郑胜能 罗淞元[1] 付明 郭晓纲[1] 李光[1] 范瑞新[1] 李捷[1] 罗建方 SUN Yinghao;ZHENG Shengneng;LUO Songyuan;FU Ming;GUO Xiaogang;LI Guang;FAN Ruixin;LI Jie;LUO Jianfang(Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所南方医科大学附属广东省人民医院(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2023年第3期267-272,278,共7页South China Journal of Cardiovascular Diseases

基　　金：广东省人民医院高水平医院建设项目(项目编号:DFJH201807);广州市科技计划项目(项目编号:202102020041);广州市科技计划项目(项目编号:2023B03J1256);广州市卫生健康委重大技术项目(项目编号:2023FTJCZ0017)。

摘　　要：目的拟评估使用球囊扩张式瓣膜(球扩瓣)进行经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)的安全性及有效性,并对初步的操作经验进行总结。方法回顾性分析2020年9月至2020年12月在广东省人民医院使用球扩瓣进行TAVR治疗的重度主动脉瓣狭窄患者的手术效果。结果6例患者均成功完成了TAVR。术后1个月内无不良事件发生,主动脉瓣狭窄改善明显,主动脉瓣平均跨瓣压差[(60.5±13.3)mmHg vs.(14.8±3.1)mmHg,P<0.001)](1 mmHg=0.133 kPa)和主动脉瓣峰值流速均显著减小[(4.9±0.6)m/s vs.(2.6±0.3)m/s,P<0.001]。结论初步经验显示,使用球扩瓣对重度主动脉瓣狭窄患者进行TAVR安全有效。可调弯输送系统和短瓣架设计是球扩瓣的主要优势。Objectives To evaluate the safety and efficacy and summarize the initial experience of transcatheter aortic valve replacement(TAVR)with a balloon-expandable valve.Methods This study retrospectively analyzed the effectiveness of TAVR with a balloon-expandable valve performed in patients with severe aortic stenosis in Guangdong Provincial People′s Hospital from September 2020 to December 2020.Results TAVR procedures were successful in all 6 cases.There was no adverse event at 1 month.Aortic stenosis was alleviated significantly,with a significant reduction in mean transaortic valve pressure gradient[(60.5±13.3)mmHg vs.(14.8±3.1)mmHg,P<0.001](1 mmHg=0.133 kPa)as well as peak aortic valve velocity[(4.9±0.6)m/s vs.(2.6±0.3)m/s,P<0.001].Conclusions Our preliminary experience showed that TAVR with a balloon-expandable valve is safe and effective in patients with severe aortic stenosis.A bendable deliver system and a short valve design are the main advantages of the balloon-expandable valve.

关 键 词：球囊扩张式瓣膜 经导管主动脉瓣置换术 主动脉瓣狭窄 

分 类 号：R543.1[医药卫生—心血管疾病]