球囊扩张瓣膜介入治疗重度主动脉瓣狭窄的单中心早期疗效观察  

Early outcome of balloon-expandable valves in the treatment of severe aortic stenosis:A single-center study

作　　者：李易航 张靖男 房芳 万俊义 徐亮[1] 潘湘斌[1] 张戈军[1] LI Yihang;ZHANG Jingnan;FANG Fang;WAN Junyi;XU Liang;PAN Xiangbin;ZHANG Gejun(Structural Heart Disease Center,National Center for Cardiovascular Disease,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.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

出　　处：《中国胸心血管外科临床杂志》2024年第7期1007-1013,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评估使用球囊扩张瓣膜行经导管主动脉瓣置换术患者的早期安全性及有效性。方法回顾性分析2020年9月—2022年6月于中国医学科学院阜外医院接受Sapien 3瓣膜治疗的重度主动脉瓣狭窄患者的临床资料。收集术后即刻、1个月、3个月、6个月、12个月的超声及随访结果。根据Sievers分型标准,将患者分为二叶式主动脉瓣组和正常组。结果纳入患者62例,其中男31例、女31例,平均年龄(71.44±9.17)岁。61例(98.39%)患者成功行经导管主动脉瓣置换术,1例转外科手术治疗。术后随访未见严重并发症及心因性死亡。超声提示术后主动脉瓣跨瓣压差低于术前(P<0.001),且此效应持续至术后12个月。球囊扩张瓣膜对不同主动脉瓣形态患者治疗后,瓣膜狭窄情况均有改善。结论应用球囊扩张瓣膜介入治疗不同瓣膜形态重度主动脉瓣狭窄患者的安全性及早期疗效良好。Objective To evaluate the safety and early-stage efficacy of transcatheter aortic valve replacement(TAVR)for severe aortic stenosis(AS)using a new generation balloon-expandable(BE)valve by collecting the baseline and follow-up data.Methods We retrospectively reviewed the clinical data of severe AS patients who received TAVR with BE valve(Sapien 3)in Fuwai Hospital from September 2020 to June 2022.We collected the echocardiographic data as well as follow-up results at post-procedure,1,3,6 and 12 months.According to the Sievers classification criteria,the patients were divided into a normal group and a bicuspid aortic valve group.Results Finally 62 patients were collected,including 31 females and 31 males with an average age of 71.44±9.17 years.There was 61 patients implanted successfully with BE valve and only 1 was transferred to surgical replacement.There was no mortality or severe complications.Echocardiographic assessment showed significant reduction of the pressure gradient(P<0.001)and the effect was consistent to postoperative 12 months.After the treatment of patients with different aortic valve morphology using balloon dilation,the condition of valve stenosis improved.Conclusion The use of BE valves has good safety and early efficacy in patients with severe AS of different valve morphology.

关 键 词：经导管主动脉瓣置换术 球囊扩张瓣膜 二叶式主动脉瓣 

分 类 号：R542.52[医药卫生—心血管疾病]