摘要
目的探讨LuX-Valve经导管三尖瓣置换(TTVR)系统血流动力学特征。方法前瞻性纳入2020年4月至2022年9月海军军医大学第一附属医院心血管外科收治的53例因重度三尖瓣关闭不全(TR)行TTVR患者,其中男性18例,年龄(65.8±9.6)岁,超声心动图提示TR瞬时反流量为(67.8±50.3)ml。所有患者在Lux-Valve置入前后利用6F猪尾巴导管分别测量有创右心房、右心室以及肺动脉压力。结果Lux-Valve置入前后右心房峰压分别为(22.5±8.4)mmHg及(20.2±7.4)mmHg(P<0.001),右心房谷压分别为(12.5±5.6)mmHg及(13.8±5.4)mmHg(P<0.05),右心房压差分别为(10.0±5.8)mmHg及(6.4±3.9)mmHg(P<0.0001)。相比于置入前,置入后右心房峰压及压差均显著下降,相反,右心房谷压显著上升。置入前后肺动脉收缩压、舒张压以及平均压未见统计学差异。结论Lux-Valve置入后在消除TR的同时可显著改善右心房压,但对肺动脉压无明显影响,右心血流动力学值得进一步研究。
Objective To investigate the hemodynamic characteristics of the Lux-Valve transcatheter tricuspid valve replacement(TTVR)system.Methods Consecutive 53 patients diagnosed with severe tricuspid regurgitation(TR)from April 2020 to September 2022 were prospectively enrolled.All the patients were admitted to the Department of Cardiovascular Surgery,the First Affiliated Hospital of Naval Medical University and underwent TTVR.There were 18 males,with an average age of(65.8±9.6)years,and the TR volume was(67.8±50.3)ml,which was identified by transthoracic echocardiography.The invasive measure of right atrial,right ventricular and pulmonary artery pressures were made before and after Lux-Valve implantation using a 6F porcine tail catheter in all patients.Results The peak right atrial pressure dropped from(22.5±8.4)mmHg to(20.2±7.4)mmHg after Lux-Valve implantation with significant difference(P<0.001).On the contrary,the nadir right atrial pressure increased from(12.5±5.6)mmHg to(13.8±5.4)mmHg after operation(P<0.05).The right atrial pressure differences decreased from(10.0±5.8)mmHg to(6.4±3.9)mmHg significantly(P<0.0001).There was no significant difference in pulmonary arterial systolic pressure,diastolic pressure and mean pressure before and after Lux-Valve implantation.Conclusion Lux-Valve implantation could significantly improve right atrial pressure and eliminate TR meanwhile but have no obvious effect on pulmonary artery pressure.The hemodynamic of right sided heart deserves further study.
作者
陈思
李宁
王伟
宁小平
杨帆
乔帆
CHEN Si;LI Ning;WANG Wei;NING Xiao-ping;YANG Fan;QIAO Fan(Department of Cardiovascular Surgery,Changhai Hospital Affiliated to the Naval Medical University,Shanghai 200433,China)
出处
《中国心血管病研究》
CAS
2023年第3期235-239,共5页
Chinese Journal of Cardiovascular Research
基金
国家重点研发计划(2022YFC2503404)
国家自然科学基金(82100383)
上海人才发展基金(2020077)。
