摘要
目的分析经导管主动脉瓣置入术(TAVI)治疗重度主动脉瓣狭窄(AS)和(或)主动脉瓣关闭不全(AR)的临床效果和安全性。方法回顾性分析2021年1月至2023年4月45例在我院行TAVI术患者的临床资料,平均年龄(71.2±7.7)岁,其中男性28例(62.2%),美国胸外科医师学会(STS)平均评分为(8.4±1.2)分,单纯重度AS 11例(24.4%),因生物瓣膜衰败导致单纯重度AR 1例(2.2%),重度AS并中度AR 8例(17.8%),重度AS并重度AR 1例(2.2%),重度AR并中度AS 3例(6.7%)。分析术后主动脉瓣血流参数及术后1个月短期随访效果。结果45例患者TAVI术均成功,术后主动脉瓣峰值血流速度下降至(2.2±0.5)m/s,主动脉瓣平均跨瓣压差下降至(10.9±5.6)mmHg。术后1个月短期随访7例(15.6%)患者有轻度瓣周漏,3例(6.7%)患者心电图出现三度房室传导阻滞,并行人工永久心脏起搏器置入,脑卒中5例(11.1%),急性冠脉事件1例(2.2%),死亡2例(4.4%)。结论对于有外科手术禁忌证或不愿意行外科手术的重度AS和(或)AR患者,经TAVI手术治疗后可有效降低跨瓣压差,改善症状,临床安全有效。
Objective To retrospective analyze clinical efficacy and safety of transcatheter aortic valve implantation(TAVI)for severe aortic stenosis(AS)and(or)aortic valve regurgitation(AR).Methods From January 2021 to April 2023,a retrospective analysis was performed for clinical data of 45 patients who underwent TAVI in our hospital,the mean age was(71.2±7.7)years,28 patients(62.2%)were male.The Society of Thoracic Surgeons predicted risk of mortality(STS)scored an average score of(8.4±1.2).There were 11 cases(24.4%)with simple severe AS alone,1 case(2.2%)with simple severe AR due to biovalve decay,8 cases(17.8%)with severe AS and AR and moderate AR,1 case(2.2%)with severe AS and AR,3 cases(6.7%)with severe AR and moderate AS.The parameters of postoperative aortic valve blood flow and the effect of short-term follow-up at 1 month after surgery were analyzed.Results All 45 patients had successful TAVI surgery,and the peak blood flow velocity of the aortic valve decreased to(2.2±0.5)m/s,and the average transvalvular pressure difference of the aortic valve decreased to(10.9±5.6)mmHg.At short-term follow-up 1 month after surgery,7 patients(15.6%)had mild paravalvular leakage,3 patients(6.7%)had three-degree atrioventricular block with artificial permanent pacemaker placement,5 cases(11.1%)of stroke,1 case(2.2%)of acute coronary event,and 2 patients(4.4%)died.Conclusion For patients with severe AS and(or)AR who have surgical contraindications or are unwilling to undergo surgery,TAVI surgery could effectively reduce transvalvular pressure difference,improve symptoms,and be clinically safe and effective.
作者
李蓉
周刚
庾辉
罗彩东
戴闽
Li Rong;Zhou Gang;Yu Hui(The Department of Cardiology,Mianyang Central Hospital,Mianyang,Sichuan 621000,China)
出处
《四川医学》
CAS
2023年第11期1186-1191,共6页
Sichuan Medical Journal
