经导管主动脉瓣置换术治疗主动脉瓣疾病的研究进展

王 万军1, 朱吉 海*2
1、青海大学
2、青海大学附属医院

摘要


现如今,经导管主动脉瓣置换术(TAVR)正在逐渐取代传统外科主动脉瓣置换术(SAVR),成为治疗重度主动脉瓣狭窄(AS)的重要方法。近几年,随着多中心、大规模、随机对照临床实验的研究,TAVR适应证不断扩大,已从高危AS患者扩展至中低危人群。同时对于单纯性主动脉瓣关闭不全(AI)患者,TAVR在不能耐受传统外科手术等高风险人群中初步显示高获益性,而随着具有锚定装置等特点的新型TAVR器械的逐渐成熟,TAVR在治疗单纯性AI方面的适应证进一步得到拓宽与夯实。并发症管理方面,瓣周漏、心律失常及冠状动脉闭塞等风险通过技术改进逐步降低。未来随着材料学的发展及医疗技术的进步,TAVR在治疗主动脉瓣疾病的安全性及有效性方面将持续优化,精准化、个性化医疗将稳步实现。因此,本文就TAVR目前发展现状及并发症管理等方面的研究进展做一综述。

关键词


经导管主动脉瓣置换术;主动脉瓣狭窄;主动脉瓣反流;适应证;手术入路;并发症;器械创新

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参考


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