孙奇, 李飞, 尹志勇, 刘毅, 刘海涛, 王博, 朱存军, 陶凌. 经导管主动脉瓣置换术在单纯自体主动脉瓣返流患者中的应用[J]. 心脏杂志, 2020, 32(2): 186-189. DOI: 10.12125/j.chj.201907024
    引用本文: 孙奇, 李飞, 尹志勇, 刘毅, 刘海涛, 王博, 朱存军, 陶凌. 经导管主动脉瓣置换术在单纯自体主动脉瓣返流患者中的应用[J]. 心脏杂志, 2020, 32(2): 186-189. DOI: 10.12125/j.chj.201907024
    Qi SUN, Fei LI, Zhi-yong YIN, Yi LIU, Hai-tao LIU, Bo WANG, Cun-jun ZHU, Ling TAO. The application of transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation[J]. Chinese Heart Journal, 2020, 32(2): 186-189. DOI: 10.12125/j.chj.201907024
    Citation: Qi SUN, Fei LI, Zhi-yong YIN, Yi LIU, Hai-tao LIU, Bo WANG, Cun-jun ZHU, Ling TAO. The application of transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation[J]. Chinese Heart Journal, 2020, 32(2): 186-189. DOI: 10.12125/j.chj.201907024

    经导管主动脉瓣置换术在单纯自体主动脉瓣返流患者中的应用

    The application of transcatheter aortic valve replacement in patients with pure native aortic valve regurgitation

    • 摘要: 经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)已经彻底改变了重度主动脉瓣狭窄的治疗方式。然而,单纯自体主动脉瓣返流(native aortic valve regurgitation,NAVR)一度被认为是TAVR的禁忌证,这是由于大部分患者主动脉瓣无钙化以及随之造成的锚定人工瓣膜困难。与主动脉瓣狭窄相比,TAVR的第一代瓣膜治疗NAVR,器械成功率较低,这是因为需要“瓣中瓣”比率以及术后中重度主动脉瓣返流复发几率较高。然而,随着新一代可回收、有裙边且有特殊固定机制瓣膜的研发与应用,此类患者的手术预后得到改善。本文对TAVR在单纯NAVR患者中的应用及两代瓣膜的临床预后进行了回顾和总结。

       

      Abstract: Transcatheter aortic valve replacement (TAVR) has revolutionized the interventional treatment of severe aortic stenosis. However, pure native aortic valve regurgitation (NAVR) has been considered as a contraindication for TAVR related to the absence of valvular calcification and the subsequent difficulty in anchoring the transcatheter valves. Compared with patients with aortic stenosis, TAVR with first-generation prostheses in NAVR was associated with lower device success rate including high incidence of second valve implantation and post-procedural aortic regurgitation (moderate or severe). However, since the application of the second-generation prostheses with retrievability, external sealing cuff and optimized anchoring mechanism, the outcomes have been greatly improved. In this review, we summarize the current issues and development of TAVR for NAVR patients.

       

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