心脏瓣膜病患者经导管介入治疗后抗栓治疗研究进展  

Advances in antithrombotic therapy in patients with valvular heart disease after transcatheter intervention

作　　者：蒙延海[1] 李露露 张燕搏[1] MENG Yanhai;LI Lulu;ZHANG Yanbo(Adult Surgery ICU,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,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心血管疾病国家重点实验室成人术后恢复中心,北京100037

出　　处：《中国胸心血管外科临床杂志》2024年第9期1363-1368,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中央高水平医院临床科研业务费(2023-GSP-QN-14,2023-GSP-GG-11,2022-GSP-GG-29);中国医学科学院医学与健康科技创新工程重大协同创新项目(2023-I2M-1-001);中央高校基本科研业务费专项资金(3332022019)。

摘　　要：随着技术的进步,目前的证据支持应用设备对心脏瓣膜病患者进行经导管介入治疗,包括经导管主动脉瓣植入术、经导管二尖瓣或三尖瓣修复术、经导管二尖瓣植入术。在介入手术围手术期均需要进行抗栓治疗以预防血栓栓塞事件,这些治疗与出血并发症风险增加相关。截至目前,关于如何平衡这些患者的血栓和出血风险存在挑战和争议,因此最佳抗栓方案仍不清晰。本文总结了目前心脏瓣膜病患者经导管介入治疗后抗栓治疗的证据,并强调个体化抗栓方法的重要性。As technology advances,current evidence supports the use of devices for valvular heart disease interventions,including transcatheter aortic valve implantation,transcatheter mitral or tricuspid valve repair,and transcatheter mitral valve implantation.These procedures require antithrombotic therapy to prevent thromboembolic events during the perioperative period,and these therapies are associated with an increased risk of bleeding complications.To date,there are challenges and controversies regarding how to balance the risk of thrombosis and bleeding in these patients,and therefore the optimal antithrombotic regimen remains unclear.In this review,we summarize the current evidence for antithrombotic therapy after transcatheter intervention in patients with valvular heart disease and highlight the importance of an individualized approach in targeting these patients.

关 键 词：抗凝 血栓栓塞 经导管主动脉瓣植入术 经导管二尖瓣植入术 综述 

分 类 号：R654.2[医药卫生—外科学]