摘要
目的探讨主动脉瓣重度狭窄患者接受经导管主动脉瓣置换术(TAVR)治疗的有效性和安全性。方法回顾性选取2017年9月至2019年12月接受TAVR的主动脉瓣重度狭窄患者36例。收集患者的人口学、实验室检查、影像辅助检查等全部临床资料,对手术过程、成功率、并发症以及手术前后超声心动图结果等进行分析。结果患者平均年龄(72.42±6.14)岁,瓣膜置入成功率100%。与术前相比,术后第1天的脑钠肽、主动脉瓣最大跨瓣压差、主动脉瓣跨瓣流速差异均有统计学意义(均P<0.01),术后6个月随访左心室射血分数、左心室舒张末期内径及左心室收缩末期内径都有显著改善(均P<0.01)。并发症方面,住院期间1例(2.8%)患者因三度房室传导阻滞行永久性起搏器植入;术后1周有2例(5.6%)患者存在轻度瓣周漏(<2 mm),术后6个月随访时只有1例(2.8%)患者存在轻度瓣周漏;术后6个月随访时1例(2.8%)患者缺血性卒中。结论主动脉瓣重度狭窄患者行TAVR治疗有较好的安全性和有效性,可有效改善左心室重塑。
Objective To investigate the safety and effectiveness of transcatheter aortic valve replacement(TAVR)in patients with severe aortic valve stenosis.Methods A total of 36 patients with severe aortic stenosis who received TAVR in our hospital from September 2017 to December 2019 were enrolled.The clinical data including demographic,laboratory examination and imaging examination were collected,and the success rate of valve implantation,incidence of various complications,postoperative cardiac function and echocardiography results were analyzed.Results The mean age was(72.42±6.14)years,valve immediate implant success rate was 100%.The differences of BNP,maximum gradient pressure across the valve,aortic peak flow velocity(all P<0.01)were statistically significant at the first day after operation.LVEF,left ventricular end-diastolic diameter and left ventricular end-systolic diameter had statistically significant improvement(all P<0.01).One week after the operation,there was 1 case(2.8%)with permanent pacemaker implantation due to third degree conduction block and 2 cases(5.6%)with mild perivalvular leakage(<2 mm).There was 1 case(2.8%)with ischemic stroke for 6 months follow up after the procedure.Conclusions TAVR treatment in patients with severe aortic stenosis has good safety and effectiveness,may have the effect of reverse remodeling on the left ventricle.
作者
冯晔子
曹丰
李苏雷
程帅
张申伟
FENG Ye-zi;CAO Feng;LI Su-lei;CHENG Shuai;ZHANG Shen-wei(Department of Cardiology,Zhengzhou Seventh People’s Hospital(Zhengzhou Cardiovascular Hospital),Zhengzhou 450000,China)
出处
《中国介入心脏病学杂志》
2022年第1期29-32,共4页
Chinese Journal of Interventional Cardiology
