经导管主动脉瓣置换术后传导阻滞及起搏器植入的预测因子研究进展  

Research progress on predictors of conduction block and pacemaker implantation after transcatheter aortic valve replacement

作　　者：范家宁 林大卫 周达新 FAN Jianing;LIN Dawei;ZHOU Daxin(Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院心内科,上海200032

出　　处：《中国临床医学》2024年第2期251-256,共6页Chinese Journal of Clinical Medicine

基　　金：上海市科学技术委员会上海市临床医学研究中心项目(19MC1910300).

摘　　要：主动脉瓣狭窄(aortic stenosis,AS)是由先天或后天因素引起的瓣膜结构改变,发病率随年龄增长而升高。经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)是一种安全可行的重度AS微创治疗方法。自2011年被FDA首次批准应用于无法进行外科手术治疗的重度AS患者以来,其适应证不断扩展至中低手术风险AS人群。人工瓣膜植入后可压迫位于主动脉根部的房室传导系统,导致术后心脏传导异常的发生,永久起搏器植入(permanent pacemaker implantation,PPMI)是其治疗手段。TAVR术后PPMI与患者预后密切相关。因此,本文对TAVR术后传导功能障碍发生及PPMI的预测因素进行综述。Aortic stenosis(AS)is a structural change in aortic valve caused by congenital or acquired factors,and its incidence increases with age.Transcatheter aortic valve replacement(TAVR)is a safe and feasible minimally invasive treatment for severe AS.Since it was first approved by FDA in 2011 for severe AS which cannot be treated surgically,its indications have been extended to AS patients with low to moderate surgical risk.The placed prosthetic valves could compress the atrioventricular conduction system at the aortic root,leading to the development of postoperative cardiac conduction abnormalities,for which permanent pacemaker implantation(PPMI)is a treatment option.And post-TAVR PPMI is closely related to the prognosis of AS patients.Therefore,this article reviews predictors of conduction dysfunction and PPMI after TAVR.

关 键 词：经导管主动脉瓣置换术 左束支阻滞 房室阻滞 永久起搏器植入 

分 类 号：R543.1[医药卫生—心血管疾病]