洪楠超,陈莎莎,张源,张晓春,潘文志,周达新,葛均波

• 1:复旦大学附属中山医院心内科
• 2:国家放射与治疗临床医学研究中心

摘要(Abstract)：

目的 评估和比较经股动脉入路经导管主动脉瓣置换术（TF-TAVR）治疗不同瓣环大小的单纯主动脉瓣反流（PAR）患者的手术成功率及短期临床预后。方法 本研究为单中心回顾性研究，选取2019年9月至2023年9月在复旦大学附属中山医院接受TF-TAVR治疗的症状性PAR患者。基于术前CT结果，将所有患者分为3组：A组（主动脉瓣环周长<80 mm）、B组（80 mm≤主动脉瓣环周长<85 mm）和C组（主动脉瓣环周长≥85 mm）。主要终点为手术成功率和术后30 d全因死亡事件，次要终点事件为TAVR相关并发症。结果 本研究共纳入PAR患者61例，其中A组27例，B组21例，C组13例。总体手术成功率为82.0%，术后30 d全因死亡率为3.3%。C组患者的手术成功率明显更低（P=0.012），其中转外科和瓣中瓣置入率明显更高（P=0.022和P=0.040）。在次要终点事件方面，3组患者在大出血事件、主要血管并发症、脑卒中、心肌梗死、新发心房颤动、植入新的起搏器、冠状动脉阻塞和术后中重度瓣周漏方面比较，差异均无统计学意义（均P>0.05）。结论 主动脉瓣环周长是影响手术成功率的关键因素之一，主动脉瓣环周长<85 mm的PAR患者可能更适合行TF-TAVR。

关键词(KeyWords)： 经导管主动脉瓣置换术;主动脉瓣反流;经股动脉;主动脉瓣环

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划项目（2020YFC2008100）;; 上海市启明星计划扬帆专项项目（22YF1443400）

作者(Author): 洪楠超,陈莎莎,张源,张晓春,潘文志,周达新,葛均波

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