应重视经导管主动脉瓣置换术结果评估与技术改进  

The Assessment of Outcomes and Technical Improvement for Transcatheter Aortic Valve Replacement Should be Given Due Attention

作　　者：吴永健[1] 陈阳[1,2] 王墨扬 张洪亮[1] 赵杰[1] WU Yongjian;CHEN Yang;WANG Moyang;ZHANG Hongliang;ZHAO Jie(Coronary Heart Disease Center,National Center for Cardiovascular Diseases and Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China;Department of Cardiology,Peking University People's Hospital,Beijing 100044,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冠心病中心,北京100037 [2]北京大学人民医院心内科,北京100044

出　　处：《中国循环杂志》2023年第11期1112-1118,共7页Chinese Circulation Journal

基　　金：国家重点研发计划(2020YFC2008103);中国医学科学院医学与健康科技创新工程(2021-I2M-C&T-A-010)。

摘　　要：近年来,经导管主动脉瓣置换术(TAVR)发展迅速且适应证逐渐向低危患者扩展。TAVR结果评估应更注重TAVR的全生命周期管理,良好的TAVR结果不仅包括即刻瓣膜置入成功,还包括患者远期预后佳和瓣膜长期耐久性好。本文初步总结TAVR的即刻、围术期、长期耐久性、冠状动脉通路、医患成本等结果评估指标,同时总结了以改善TAVR结果为目的的TAVR瓣膜研发及技术改进的进展,包括置入技术、短瓣架和瓣叶处理技术、主动脉瓣反流瓣膜的锚定技术、极具成本效益的极简式技术等,为今后TAVR的发展指明方向。Transcatheter aortic valve replacement(TAVR)has developed rapidly and its indications are gradually expanding to low-risk patients.Good outcomes of TAVR include immediate valve implantation success,long-term prognosis,and valve durability.Recently,more attention has been paid to the concept of full-life management for TAVR patients.This article preliminarily summarizes the evaluation indicators for the immediate,perioperative,long-term durability,coronary access,and physician-patient costs of TAVR.At the same time,it outlines the evaluation of related TAVR technologies for improving outcomes,including implantation technology,short-stent valve and leaf-processing technology,aortic regurgitation devices,and minimalist TAVR technology,indicating the direction for the future development of TAVR.

关 键 词：经导管主动脉瓣置换术 结果评估 技术改进 

分 类 号：R54[医药卫生—心血管疾病]