3D打印技术应用于经导管主动脉瓣置换术前冠状动脉阻塞风险评估1例

刘健迪, 龚韧, 徐劲松, 等. 3D打印技术应用于经导管主动脉瓣置换术前冠状动脉阻塞风险评估1例[J]. 临床心血管病杂志, 2023, 39(4): 320-323. doi: 10.13201/j.issn.1001-1439.2023.04.016
引用本文: 刘健迪, 龚韧, 徐劲松, 等. 3D打印技术应用于经导管主动脉瓣置换术前冠状动脉阻塞风险评估1例[J]. 临床心血管病杂志, 2023, 39(4): 320-323. doi: 10.13201/j.issn.1001-1439.2023.04.016
LIU Jiandi, GONG Ren, XU Jinsong, et al. Application of 3D printing in the risk assessment of coronary artery obstruction before transcatheter aortic valve replacement: a case report[J]. J Clin Cardiol, 2023, 39(4): 320-323. doi: 10.13201/j.issn.1001-1439.2023.04.016
Citation: LIU Jiandi, GONG Ren, XU Jinsong, et al. Application of 3D printing in the risk assessment of coronary artery obstruction before transcatheter aortic valve replacement: a case report[J]. J Clin Cardiol, 2023, 39(4): 320-323. doi: 10.13201/j.issn.1001-1439.2023.04.016

3D打印技术应用于经导管主动脉瓣置换术前冠状动脉阻塞风险评估1例

  • 基金项目:
    江西省优势科技创新团队建设计划(No:20181BCB24013);江西省重点研发计划(No:20203BBG73057、20212BBG71004)
详细信息

Application of 3D printing in the risk assessment of coronary artery obstruction before transcatheter aortic valve replacement: a case report

More Information
  • 冠状动脉阻塞是经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)少见却致命的并发症,然而尚无公认的标准方案应用于此并发症的风险评估。目前, 针对TAVR冠状动脉阻塞风险评估最常用的方法是通过影像学直接评估, 但是瓣膜部署后钙化团块的真实偏转情况很难被精确预测。因此, 该风险评估可能受到经验主义的影响, 从而导致评估结果出现偏差。本文报道TAVR术前应用3D打印技术精确评估冠状动脉阻塞风险1例, 为临床诊治提供经验参考。
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  • 图 1  术前主动脉CTA

    Figure 1.  Preoperative aortic CTA

    图 2  应用3D打印模型评估冠脉阻塞风险

    Figure 2.  Application of 3D printing model in the risk assessment of coronary artery occlusion

    图 3  术中主动脉造影

    Figure 3.  Intraoperative aortic angiography

    图 4  术后主动脉CTA

    Figure 4.  Postoperative aortic CTA

  • [1]

    周达新, 潘文志, 吴永健, 等. 经导管主动脉瓣置换术中国专家共识(2020更新版)[J]. 中国介入心脏病学杂志, 2020, 28(6): 301-309. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXB202006001.htm

    [2]

    祝磊, 欧袁伟翔, 李茜, 等. 经导管主动脉瓣置换术并发冠状动脉阻塞的研究进展[J]. 华西医学, 2020, 35(9): 1039-1043. https://www.cnki.com.cn/Article/CJFDTOTAL-HXYX202009005.htm

    [3]

    Liu JD, Luo XD, Zhou ZP, et al. Annular and supra-annular structure assessments for transcatheter aortic valve replacement in patients with bicuspid aortic stenosis[J]. Rev Cardiovasc Med, 2021, 22(4): 1157-1166. doi: 10.31083/j.rcm2204124

    [4]

    Kapadia SR, Leon MB, Makkar RR, et al. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis(PARTNER 1): a randomised controlled trial[J]. Lancet, 2015, 385(9986): 2485-2491. doi: 10.1016/S0140-6736(15)60290-2

    [5]

    Mack MJ, Leon MB, Thourani VH, et al. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients[J]. N Engl J Med, 2019, 380(18): 1695-1705. doi: 10.1056/NEJMoa1814052

    [6]

    Kodali S, Pibarot P, Douglas PS, et al. Paravalvular regurgitation after transcatheter aortic valve replacement with the Edwards sapien valve in the PARTNER trial: characterizing patients and impact on outcomes[J]. Eur Heart J, 2015, 36(7): 449-456. doi: 10.1093/eurheartj/ehu384

    [7]

    Hansson NC, Grove EL, Andersen HR, et al. Transcatheter Aortic Valve Thrombosis: Incidence, Predisposing Factors, and Clinical Implications[J]. J Am Coll Cardiol, 2016, 68(19): 2059-2069. doi: 10.1016/j.jacc.2016.08.010

    [8]

    Ribeiro HB, Rodés-Cabau J, Blanke P, et al. Incidence, predictors, and clinical outcomes of coronary obstruction following transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: insights from the VIVID registry[J]. Eur Heart J, 2018, 39(8): 687-695. doi: 10.1093/eurheartj/ehx455

    [9]

    Ribeiro HB, Webb JG, Makkar RR, et al. Predictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registry[J]. J Am Coll Cardiol, 2013, 62(17): 1552-1562. doi: 10.1016/j.jacc.2013.07.040

    [10]

    Arai T, Lefèvre T, Hovasse T, et al. Incidence and predictors of coronary obstruction following transcatheter aortic valve implantation in the real world[J]. Catheter Cardiovasc Interv, 2017, 90(7): 1192-1197. doi: 10.1002/ccd.26982

    [11]

    Webb JG, Chandavimol M, Thompson CR, et al. Percutaneous aortic valve implantation retrograde from the femoral artery[J]. Circulation, 2006, 113(6): 842-850. doi: 10.1161/CIRCULATIONAHA.105.582882

    [12]

    Fetahovic T, Hayman S, Cox S, et al. The Prophylactic Chimney Snorkel Technique for the Prevention of Acute Coronary Occlusion in High Risk for Coronary Obstruction Transcatheter Aortic Valve Replacement/Implantation Cases[J]. Heart Lung Circ, 2019, 28(10): e126-e130. doi: 10.1016/j.hlc.2019.04.009

    [13]

    Rivard AL, Bartel T, Bianco RW, et al. Evaluation of aortic root and valve calcifications by multi-detector computed tomography[J]. J Heart Valve Dis, 2009, 18(6): 662-670.

    [14]

    Ribeiro HB, Nombela-Franco L, Urena M, et al. Coronary obstruction following transcatheter aortic valve implantation: a systematic review[J]. JACC Cardiovasc Interv, 2013, 6(5): 452-461. doi: 10.1016/j.jcin.2012.11.014

    [15]

    Spina R, Khalique O, George I, et al. Acute left main stem coronary occlusion following transcatheter aortic valve replacement in a patient without recognized coronary obstruction risk factors: a case report[J]. Eur Heart J Case Rep, 2018, 2(4): yty112.

    [16]

    陈强, 姜益, 郝军军, 等. 3D打印技术在经导管主动脉瓣置换手术中应用价值分析[J]. 临床军医杂志, 2021, 49(11): 1244-1247. https://www.cnki.com.cn/Article/CJFDTOTAL-JYGZ202111021.htm

    [17]

    Maragiannis D, Jackson MS, Igo SR, et al. Replicating Patient-Specific Severe Aortic Valve Stenosis With Functional 3D Modeling[J]. Circ Cardiovasc Imaging, 2015, 8(10): e003626. doi: 10.1161/CIRCIMAGING.115.003626

    [18]

    Thériault-Lauzier P, Messika-Zeitoun D, Piazza N. Patient-Specific Computer Simulation in TAVR: Will the Technology Gain Widespread Adoption?[J]. JACC Cardiovasc Interv, 2020, 13(15): 1813-1815. doi: 10.1016/j.jcin.2020.05.021

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出版历程
收稿日期:  2022-05-24
刊出日期:  2023-04-13

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