高雪,杨凯敬,刘思绪,张曙影,于胜钦

• 1:大连医科大学研究生院
• 2:大连大学附属中山医院心内科

摘要(Abstract)：

经导管主动脉瓣置换术（TAVR）是通过患者的动静脉系统或左心室心尖，利用介入导管将人工心脏瓣膜输送至主动脉瓣区后释放，替代原有主动脉瓣实现正常的生理功能。“自杀左室”现象是指TAVR后解除主动脉瓣狭窄的固定瓣膜阻塞后，由于左心室肥厚和收缩亢进等机制导致动态左心室梗阻的发生，进而出现的自相矛盾的血流动力学崩溃现象，临床表现为术中或术后数小时内发生的对正性肌力药物无效的反常持续低血压。随着经导管主动脉瓣手术适应证涵盖低中高危重度主动脉瓣狭窄患者，手术相关并发症报道逐渐增多，“自杀左室”这种致命的潜在并发症值得研究和探索。本文主要从“自杀左室”的概述、病理机制、风险相关指标、预防策略及治疗方法4个方面进行综述，以期对可能有“自杀左室”风险的主动脉瓣狭窄患者高度警惕并做好相应应急预案，从而最大限度地降低围术期死亡率。

关键词(KeyWords)： 自杀左室;主动脉瓣狭窄;经导管主动脉瓣置换术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高雪,杨凯敬,刘思绪,张曙影,于胜钦

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