王伟敏,杨杰,李琳琳,张智翔,王丽岚,王斌,王焱

• 1:厦门大学附属心血管病医院心内科

摘要(Abstract)：

经导管主动脉瓣置换术（TAVR）已成为老年主动脉瓣狭窄的一线治疗手段。本文报道1例高风险，合并完全性右束支传导阻滞、左冠状动脉开口低、外周动脉粥样硬化的重度主动脉瓣狭窄患者，术前经本院结构性心脏病团队详细评估后，成功经股动脉路径完成TAVR，术后患者出现三度房室传导阻滞，并于术后第1天行左束支起搏，明显改善了患者的心功能，为TAVR围术期新发传导阻滞的干预提供借鉴。

关键词(KeyWords)： 经导管主动脉瓣置换术;主动脉瓣狭窄;左束支起搏

Abstract:

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基金项目(Foundation): 厦门市联合支持医疗卫生重点项目（3502Z20209006）

作者(Author): 王伟敏,杨杰,李琳琳,张智翔,王丽岚,王斌,王焱

参考文献(References)：

• [1]周达新，潘文志，吴永健，等.经导管主动脉瓣置换术中国专家共识（2020更新版）[J].中国介入心脏病学杂志，2020,28(6):301-309.
• [2] Ribeiro HB,Webb JG,Makkar RR,et al. Predictive factors,management,and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation:insights from a large multicenter registry[J]. J Am Coll Cardiol,2013,62(17):1552-1562.
• [3] Ribeiro HB,Nombela-Franco L,Urena M,et al. Coronary obstruction following transcatheter aortic valve implantation:a systematic review[J]. JACC Cardiovasc Interv,2013,6(5):452-461.
• [4] Buellesfeld L,Stortecky S,Kalesan B,et al. Aortic root dimensions among patients with severe aortic stenosis undergoing transcatheter aortic valve replacement[J]. JACC Cardiovasc Interv,2013,6(1):72-83.
• [5] Moreno R,Dobarro D,López de SáE,et al. Cause o f complete atrioventricular block after percutaneous aortic valve implantation:insights from a necropsy study[J].Circulation,2009,120(5):e29-e30.
• [6] Regueiro A,A bdul-J aw ad Altis ent O,Del Tri go M, et al. Impact of new-onset left bundle branch block and periprocedural permanent pacemaker implantation on clinical outcomes in patients undergoing transcatheter aortic valve replacement:a systematic review and meta-analysis[J].Circ Cardiovasc Interv,2016,9(5):e003635.
• [7] Siontis GC,Jüni P,Pilgrim T,et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR:a meta-analysis[J]. J Am Coll Cardiol,2014,64(2):129-140.
• [8] Sharma PS,Dandamudi G,Herweg B,et al. Permanent Hisbundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy:a multicenter experience[J]. Heart Rhythm,2018,15(3):413-420.
• [9] Huang W,Chen X,Su L,et al. A beginner’s guide to permanent left bundle branch pacing[J]. Heart Rhythm,2019,16(12):1791-1796.
• [10] Vijayaraman P,Canoó，Koruth JS,et al. His-purkinje conduction system pacing following transcatheter aortic valve replacement:feasibility and safety[J]. JACC Clin Electrophysiol,2020,6(6):649-657.
• [11] Rodés-Cabau J, Ellenbogen K A, Krahn A D, et al. Management of conduction disturbances associated with transcatheter aortic valve replacement:JACC scientific expert panel[J]. J Am Coll Cardiol,2019,74(8):1086-1106.
• [12] Wu S,Chen X,Wang S,et al. Evaluation of the criteria to distinguish left bundle branch pacing from left ventricular septal pacing[J]. JACC Clin Electrophysiol,2021,7(9):1166-1177.