经皮冠状动脉介入治疗联合经导管主动脉瓣置换术“一站式”手术在肝硬化失代偿期患者中的应用1例Percutaneous coronary intervention combined with transcatheter aortic valve replacement in patient with decompensated cirrhosis:a case report
付源,夏昆,张智勇,何冀芳,徐立,王乐丰
摘要(Abstract):
经导管主动脉瓣置换术(TAVR)已成为存在外科手术禁忌或手术中、高风险的症状性重度主动脉瓣狭窄(AS)患者的一线治疗方案。本文报道1例肝硬化失代偿期合并严重冠状动脉病变的重度AS患者,经心脏团队精准评估后成功行经皮冠状动脉介入治疗(PCI)联合TAVR“一站式”手术,术后6个月随访预后良好,为临床类似病例的治疗提供了参考。
关键词(KeyWords): 经导管主动脉瓣置换术;经皮冠状动脉介入治疗;一站式手术;肝硬化失代偿期
基金项目(Foundation):
作者(Author): 付源,夏昆,张智勇,何冀芳,徐立,王乐丰
参考文献(References):
- [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.
- [2] Avvedimento M, Tang GHL. Transcatheter aortic valve replacement(TAVR):recent updates[J]. Prog Cardiovasc Dis,2021,69:73-83.
- [3] Otto CM,Lind BK,Kitzman DW,et al. Association of aorticvalve sclerosis with cardiovascular mortality and morbidity in the elderly[J]. N Engl J Med,1999,341(3):142-147.
- [4] Iung B,Cachier A,Baron G,et al. Decision-making in elderly patients with severe aortic stenosis:why are so many denied surgery[J]?Eur Heart J,2005,26(24):2714-2720.
- [5] Nishimura RA,Otto CM,Bonow RO,et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines[J]. J Am Coll Cardiol,2017,70(2):252-289.
- [6] Still S, Szerlip M, Mack M. TAVR vs. SAVR in intermediaterisk patients:what infl uences our choice of therapy[J]. Curr Cardiol Rep,2018,20(10):82.
- [7] Sammour Y, Krishnaswamy A, Kumar A, et al. Incidence,predictors, and implications of permanent pacemaker requirement after transcatheter aortic valve replacement[J].JACC Cardiovasc Interv,2021,14(2):115-134.
- [8] Davidson LJ, Davidson CJ. CAD strategy in the TAVR era[J].Catheter Cardiovasc Interv,2019,93(3):553-554.
- [9] De Backer O, Landes U, Fuchs A, et al. Coronary access after TAVR-in-TAVR as evaluated by multidetector computed tomography[J]. JACC Cardiovasc Interv,2020,13(21):2528-2538.
- [10] Faroux L,Guimaraes L,Wintzer-Wehekind J,et al. Coronary artery disease and transcatheter aortic valve replacement:JACC state-of-the-art review[J]. J Am Coll Cardiol,2019,74(3):362-372.
- [11] Walther T,Hamm CW,Schuler G,et al. Perioperative results and complications in 15,964 transcatheter aortic valve replacements:prospective data from the GARY registry[J].J Am Coll Cardiol,2015,65(20):2173-2180.
- [12] Witberg G,Zusman O,Codner P,et al. Impact of coronary artery revascularization completeness on outcomes of patients with coronary artery disease undergoing transcatheter aortic valve replacement:a meta-analysis of studies using the residual SYNTAX score(synergy between PCI with taxus and cardiac surgery)[J].Circ Cardiovasc Interv,2018,11(3):e006000.
- [13] Lateef N,Khan MS,Deo SV,et al. Meta-analysis comparing outcomes in patients undergoing transcatheter aortic valve implantation with versus without percutaneous coronary intervention[J]. Am J Cardiol,2019,124(11):1757-1764.
- [14]王墨扬,宋光远,牛冠男,等.冠状动脉旋磨及支架置入+TAVR“一站式”手术的可行性探讨[J].中华心血管病杂志,2021,49(1):66-70.
- [15] Bajaj A, Pancholy S, Sethi A, et al. Safety and feasibility of PCI in patients undergoing TAVR:a systematic review and meta-analysis[J]. Heart Lung,2017,46(2):92-99.
- [16] Bao L,Gao Q,Chen S,et al. Feasibility and safety o f combined percutaneous coronary intervention among highrisk patients with severe aortic stenosis undergoing transcatheter aortic valve implantation:a systematic review and metaanalysis[J]. Eur J Cardiothorac Surg,2018,54(6):1052-1059.
- [17]王斌,杨杰,陈翔,等.多合并症低流速低压差重度主动脉瓣狭窄经颈动脉入径行经导管主动脉瓣置换术1例[J].中国介入心脏病学杂志,2021,29(2):112-115.
- [18] Goel SS,Ige M,Tuzcu EM,et al. Severe aortic stenosis and coronary artery disease--implications for management in the transcatheter aortic valve replacement era:a comprehensive review[J].J Am Coll Cardiol,2013,62(1):1-10.
- [19] Xiao J,Wang F,Wong NK,et al. Global liver disease burdens and research trends:analysis from a Chinese perspective[J]. J Hepatol,2019,71(1):212-221.
- [20]马春燕,于苏淮. 2012—2019年院内丙肝肝硬化失代偿期患者流行病学调查[J].公共卫生与预防医学,2021,32(2):55-58.
- [21]罗永祥,周涛.全身免疫炎症指数对失代偿期肝硬化患者预后的评估价值[J/OL].中国肝脏病杂志(电子版),2021,13(1):52-58.
- [22] Marmagkiolis K, Monlezun DJ, Cilingiroglu M, et al. TAVR in cancer patients:comprehensive review, meta-analysis,and meta-regression[J]. Front Cardiovasc Med,2021,8:641268.
- [23] Penkalla A,Pasic M,Drews T,et al. Transcatheter aortic valve implantation combined with elective coronary artery stenting:a simultaneous approachdagger[J]. Eur J Cardiothorac Surg,2015,47(6):1083-1089.
- [24] Veulemans V, Afzal S, Papadopoulos G, et al. TAVR-related echocardiographic assessment-status quo, challenges and perspectives[J]. Acta Cardiol,2020,75(4):275-285.
- [25] Bleakley C, Monaghan M. 3D transesophageal echocardiography in TAV R[J]. Echocardiography,2020,37(10):1654-1664.
- [26] Writing Committee Members, Lawton JS, Tamis-Holland JE, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization:a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines[J]. J Am Coll Cardiol,2022,79(2):e21-e129.
- [27] O'Malley RG, Mahaffey KW, Fearon WF. Adjuvant Antithrombotic Therapy in TAVR[J]. Curr Cardiol Rep,2017,19(5):41.