经导管主动脉瓣置换术治疗重度主动脉瓣狭窄的初步临床疗效分析

李光照; 王明蛟; 胡彩娜; 户富栋; 姜正明; 陈魁

doi:10.13201/j.issn.1001-1439.2020.03.019

经导管主动脉瓣置换术治疗重度主动脉瓣狭窄的初步临床疗效分析

- 1 郑州大学第一附属医院心内科(郑州, 450000)

详细信息

通讯作者: 陈魁,E-mail:2524231099@qq.com

中图分类号: R542.5

收稿日期: 2019-11-21

修回日期: 2019-12-25

Preliminary clinical efficacy of transcatheter aortic valve replacement for severe aortic stenosis

- Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China

More Information

Corresponding author: CHEN Kui, E-mail: 2524231099@qq.com

Received Date: 21 November 2019

Revised Date: 25 December 2019

摘要

摘要: 目的:总结经导管主动脉瓣置换术(TAVR)治疗重度主动脉瓣狭窄(AS)的初步临床经验。方法:纳入2018年10月-2019年10月于我院接受TAVR治疗的重度AS患者21例,分析其临床资料、手术效果及并发症情况。结果:患者平均年龄(73.71±8.91)岁,男9例,女12例。手术成功率为100%,术后即刻主动脉瓣跨瓣压差较术前明显下降[(7.71±5.32) mmHg∶(100.19±30.13) mmHg,1 mmHg=0.133 kPa,P＜0.01]。术中联合ECMO支持1例,联合经导管二尖瓣球囊扩张1例,联合经皮冠状动脉支架植入术(PCI)1例,瓣中瓣植入2例。术后消化道出血1例,永久性起搏器植入2例,发热2例,急性脑梗死1例,轻度瓣周漏11例,股动脉穿刺点处假性动脉瘤1例,临时起搏器置入处皮下血肿1例,死亡1例。术后30 d患者症状及心脏超声指标均改善。结论:TAVR治疗外科手术禁忌或高危重度主动脉瓣狭窄相对安全、有效。
- 经导管主动脉瓣置换 /
- 主动脉瓣狭窄 /
- 临床疗效
Abstract: Objective:To summarize the preliminary experience of transcatheter aortic valve replacement(TAVR) in the treatment of severe aortic stenosis(AS).Method:Twenty-one patients with severe AS who underwent TAVR in the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2019 were enrolled.The clinical data,surgical results,and complications were analyzed.Result:The mean age of patients(73.71±8.91) years,9 males,12 females.The success rate of surgery was 100% and the aortic valve transvalvular pressure difference decreased immediately after surgery compared with preoperative [(7.71±5.32) mmHg ∶(100.19±30.13) mmHg,P＜0.01].There were 1 case of intraoperative combined with ECMO support,1 case of combined with transcatheter mitral balloon dilatation,1 case combined with coronary artery stenting(PCI),2 cases of anterior valve implantation,1 case of postoperative gastrointestinal bleeding,2 cases of permanent pacemaker implantation,2 cases of fever,1 case of acute cerebral infarction,11 cases of mild perivalvular leakage,1 case of pseudoaneurysm at the femoral artery puncture point,1 case of subcutaneous hematoma with temporary pacemaker placement,and 1 case of death.The symptoms and cardiac ultrasound index improved after 30 days of follow-up.Conclusion:TAVR is safe and effective in the treatment of surgical contraindications or high-risk severe aortic stenosis.
- transcatheter aortic valve replacement /
- aortic stenosis /
- clinical efficacy

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