徐承义,苏晞,何亚峰

• 1:武汉亚洲心脏病医院心内科
• 2:武汉亚洲心脏病医院超声科

摘要(Abstract)：

<正>瓣周漏(paravalvular leak,PVL)是瓣膜置换术后最具挑战性的并发症。多数PVL无明显临床症状,少数可引起严重临床事件,如心力衰竭和溶血。二次外科修复或二次瓣膜置换是治疗PVL的金标准,但是二次手术技术难度大,风险高,手术死亡率高[1-2]。1992年首次报道PVL经导管介入封堵术(以下简称"介入封堵")治疗成功的案例[3]。在此后近30年时间里,介入封堵技术及封堵器械不断发展,目前介入封堵治疗已成为PVL的一线治疗方案。在2017年更新的美国心脏协会(American Heart Association,AHA)/美国心脏病学学会(American College of Cardiology,ACC)心脏瓣膜病管理指南中,对存在反复溶血和(或)纽约心脏病协会(New York Heart Association,NYHA)心功能分级Ⅲ～Ⅳ级且外科手术高危的PVL患者,如解剖条件适宜封堵,建议首选介入封堵治疗(Ⅱa类推荐)[4]。循证医学的证据主要源于主动脉瓣或二尖瓣置换术后PVL的介入封堵治疗,这也是本文介绍的重点。本文就PVL介入封堵治疗的现状进行综述。

关键词(KeyWords)： 瓣膜置换术;瓣周漏;经导管介入封堵术;封堵器

Abstract:

Keywords:

基金项目(Foundation): 武汉市卫生健康委员会青年项目（WX19Q13）

作者(Author): 徐承义,苏晞,何亚峰

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