彭彦人,聂如琼,陈样新,林永青

• 1:中山大学孙逸仙纪念医院心血管内科

摘要(Abstract)：

单纯主动脉瓣反流（PAR）是一种常见且逐渐加重的瓣膜性心脏病，严重影响患者的预后。外科主动脉瓣置换术（SAVR）是目前治疗重度PAR的首选方案，但对于外科手术高危或无法接受外科治疗的PAR患者，经导管主动脉瓣置入术（TAVI）已成为一种重要的替代方案。TAVI在PAR患者中的应用仍面临显著挑战，主要与瓣叶缺乏钙化、主动脉瓣环及根部扩张等解剖特点导致的瓣膜锚定和尺寸选择困难有关。近年来，随着新一代经导管心脏瓣膜（THV）的出现，手术成功率显著提高，瓣周漏发生率有所下降。然而，TAVI在PAR患者中的预后仍然受到多个因素的影响，如瓣膜选择、患者解剖特征及干预时机等。研究表明，个体化评估和优化器械选择对改善TAVI疗效具有重要意义。此外，新一代THV设备与SAVR的比较显示，在PAR患者中，TAVI在减少住院并发症和住院时间方面具有明显优势，但在长期结局、瓣膜耐久性及永久起搏器植入率等方面仍存在挑战。未来的研究应聚焦于解决这些问题，以进一步提高TAVI在PAR患者中的临床应用价值。

关键词(KeyWords)： 经导管主动脉瓣置入术;单纯主动脉瓣反流;外科主动脉瓣置换术;标签内瓣膜;长期预后;瓣膜创新

Abstract:

Keywords:

基金项目(Foundation): 2024年广东省援疆农村科技[特派员]项目（KTPYJ2024029）;; 2024年逸仙博士后启航项目（9390025007）;; 广州市科技项目（202206080014）

作者(Author): 彭彦人,聂如琼,陈样新,林永青

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