陈思毅,刘健迪,刘航宇,魏海霞,李垚,张诗渊,龚韧,吴延庆

• 1:南昌大学第二附属医院心血管内科

摘要(Abstract)：

目的 分析经导管主动脉瓣置换术（TAVR）后发生中度以上瓣周漏（PVL）患者的临床特征和危险因素。方法 本单中心研究回顾性分析了2018年1月至2022年11月在南昌大学第二附属医院心血管内科接受TAVR治疗的重度主动脉瓣狭窄患者，并根据瓣膜置入后即刻经食管超声心动图测得的主动脉瓣反流束长度与瓣环周长之比，将患者分为PVL<3/4组和PVL≥3/4组（中度以上PVL），对比两组患者的临床特征、超声心动图及主动脉根部CT扫描分析结果。采用多因素Logistic回归模型，对术后PVL≥3/4的独立危险因素进行筛选，并通过受试者工作特征（ROC）曲线分析各危险因素对PVL≥3/4的预测价值。结果 共纳入107例患者，平均年龄（71.7±7.0）岁，其中男63例（58.9%）。PVL<3/4组70例，PVL≥3/4组37例。多因素Logistic回归分析显示，相对室壁厚度的倒数（RWTd,OR2.697,95CI 1.168～6.229,P=0.020）以及钙化体积（OR1.001,95%CI1.100～1.002,P=0.026）是行TAVR置入Venus-A瓣膜术后发生中度以上PVL的独立危险因素。ROC曲线显示，RWTd(AUC=0.658,95%CI0.554～0.763,P=0.007)、钙化体积（AUC=0.657,95%CI0.554～0.759,P=0.008）均可预测TAVR术后中度以上PVL的发生。结论 中度以上PVL患者术前左心室重构较严重，且左心室射血分数在正常范围低值；RWTd以及主动脉瓣钙化体积是TAVR术后发生中度以上PVL的独立危险因素，两者对预测术后严重PVL具有一定价值。

关键词(KeyWords)： 主动脉瓣狭窄;经导管主动脉瓣置换术;瓣周漏

Abstract:

Keywords:

基金项目(Foundation): 江西省重点研发计划项目（20203BBG73057）

作者(Author): 陈思毅,刘健迪,刘航宇,魏海霞,李垚,张诗渊,龚韧,吴延庆

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