主动脉瓣狭窄和主动脉瓣反流患者的主动脉解剖学比较Comparisons of aortic anatomy between aortic stenosis and aortic regurgitation
白英楠,邓欣,张亚琦,李智行,潘文志,周达新,葛均波
摘要(Abstract):
目的通过多排计算机断层成像(multi-detector computed tomography,MDCT)和超声心动图,比较严重主动脉瓣狭窄(aortic stenosis,AS)和主动脉瓣反流(aortic regurgitation,AR)患者主动脉根部解剖特征,为AR新型器械设计和经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)的治疗提供参考。方法纳入2014年4月至2016年5月连续入组就诊于上海复旦大学附属中山医院,患有严重AS或AR并计划接受TAVR治疗的患者共170例,其中包括AR组57例,AS组113例。所有患者均接受MDCT和超声心动图检查,并对测量数据进行分析。结果AR组患者平均主动脉瓣环直径[(26.4±3.7)mm比(25.2±2.9)mm,P=0.001]、平均升主动脉直径[(38.3±6.9)mm比(33.9±6.7)mm,P<0.001]和主动脉窦直径[(38.9±6.9)mm比(32.7±4.5)mm,P<0.001]均大于AS组患者,差异均有统计学意义。两组患者左冠状动脉开口高度比较,差异无统计学意义(P=0.080);AR组患者右冠状动脉开口高度[(17.5±5.0)mm比(15.3±3.3)mm,P=0.010]高于AS组患者,差异有统计学意义。结论 AS和AR患者主动脉解剖学比较结果可为AR新型器械设计和TAVR治疗提供有价值的信息参考。
关键词(KeyWords): 主动脉瓣反流;经导管主动脉瓣置换术;主动脉瓣狭窄;主动脉根部解剖
基金项目(Foundation): 中山青年基金(2015ZSYXQN25)
作者(Author): 白英楠,邓欣,张亚琦,李智行,潘文志,周达新,葛均波
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