经动脉入路经导管主动脉瓣置换术治疗单纯主动脉瓣反流的初步经验Preliminary experience of trans-arterial transcatheter aortic valve replacement in pure aortic regurgitation
李捷,孙英皓,李光,付明,莫与京,郑胜能,董豪坚,范瑞新,罗建方
摘要(Abstract)：
目的探索经动脉入路经导管主动脉瓣置换术(TAVR)治疗单纯主动脉瓣反流的安全性及有效性。方法本研究为回顾性研究。选取2016年4月至2021年7月在广东省人民医院行经动脉入路TAVR治疗的症状性单纯重度主动脉瓣反流患者。重度主动脉瓣反流由经胸超声心动图诊断,且主动脉瓣平均跨瓣压差≤20 mmHg(1 mmHg=0.133 kPa)。主要终点为术后1个月的全因死亡。采用配对样本t检验比较基线和术后经胸超声心动图指标。结果共入选16例患者,平均年龄(75.1±5.5)岁,男9例(9/16)。术中置入第二个瓣膜2例,术后残余中重度主动脉瓣反流1例,器械成功率为14/16。术后1个月内急性肾损伤(2级或3级)、新发心房颤动和永久起搏器植入各1例(1/16),未发生死亡、卒中、心肌梗死、严重出血或主要血管并发症事件。TAVR术后主动脉瓣反流面积显著减小[(2.2±3.4)cm~2比(9.7±2.2)cm~2,Δ=(–7.4±2.5)cm~2,P<0.001],左心室舒张末期内径显著减小[(54.1±6.8)mm比(60.8±5.7)mm,Δ=(–6.6±5.6)mm,P<0.001],左心室射血分数无显著变化[(49.4±12.4)%比(51.2±12.7)%,Δ=(–1.8±12.2)%,P=0.563]。结论经动脉入路TAVR治疗单纯主动脉瓣反流是可行的。
关键词(KeyWords)： 经导管主动脉瓣置换术;主动脉瓣反流;股动脉;颈动脉
基金项目(Foundation): 广东省人民医院高水平医院建设项目（DFJH201807）
作者(Author): 李捷,孙英皓,李光,付明,莫与京,郑胜能,董豪坚,范瑞新,罗建方
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