经导管主动脉瓣置换术时代外科医师的重任:全生命周期管理  

The surgeon's crucial role in the era of transcatheter aortic valve replacement:lifetime management

作　　者：谭桐 朱恩军[1] 崔颢 来永强[1] TAN Tong;ZHU En-jun;CUI Hao;LAI Yong-qiang(Cardiac Surgery Center,Beijing Anzhen Hospital,Capital Medical University Beijing Institute of Cardiovascular and Pulmonary Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科中心、北京市心肺血管疾病研究所,北京100029

出　　处：《中国介入心脏病学杂志》2025年第4期227-230,共4页Chinese Journal of Interventional Cardiology

基　　金：国家自然科学基金优秀青年基金项目和首都医科大学优秀青年项目(KCA2305);首都医学科学创新中心项目(CX23YQA05);北京安贞医院国家心血管疾病临床医学研究中心高水平研究专项项目(2024AZC1003);北京市自然科学基金项目(7222042)。

摘　　要：经导管主动脉瓣置换术(TAVR)在低危和低龄患者中的应用日益增加。然而,这一趋势要求心外科医师承担起更为复杂的全生命周期管理的重任。本文探讨了3个全生命周期管理的重点,包括第1枚瓣膜的选择、TAVR的手术成功率与器械成功率以及瓣膜耐久性。TAVR患者年轻化,需考虑其全生命周期管理的复杂性,包括可能的二次手术风险。提高TAVR的手术成功率与器械成功率,是全生命周期管理的基石,需在手术策略和操作层面努力降低并发症的发生。瓣膜耐久性是全生命周期管理的保障,目前的外科生物瓣膜耐久性良好,但TAVR瓣膜的长期耐久性数据仍需进一步积累。同时,新型瓣膜在耐久性方面不断改良,为优化TAVR患者的全生命周期管理提供了新方向。Transcatheter aortic valve replacement(TAVR)is increasingly being applied in low-risk and younger patients.However,this trend necessitates that cardiac surgeons take on the responsibility of comprehensive lifetime management.This article explores three critical aspects of lifetime management,including the selection of the initial valve,the procedural success and the device success rates of TAVR,and the durability of the valve.Younger TAVR recipients require comprehensive lifetime management strategies,including the potential risk of reintervention.Improving TAVR's procedural and device success rates is the cornerstone of lifetime management,necessitating efforts in surgical strategy and operation to reduce complications.Valve durability is a key guarantee;current surgical bioprosthetic valves show good durability,but long-term data on TAVR valves'durability is still needed.Meanwhile,novel valves are being improved in durability,offering new directions for optimizing lifetime management in TAVR patients.

关 键 词：经导管主动脉瓣置换术 外科主动脉瓣置换术 介入治疗 全生命周期管理 瓣膜耐久性 

分 类 号：R5[医药卫生—内科学]