外科瓣膜置换术后瓣周漏相关性溶血的机制探讨及介入治疗进展

Mechanism of paravalvular leak hemolysis after surgical valve replacement and progress of interventional therapy

人工瓣膜置换术后瓣周漏(PVL)是外科瓣膜置换术后较常见的并发症之一,临床表现为心功能不全和(或)溶血。相较而言,溶血多发生在机械金属瓣置换术后,发生率相对较低且易被忽视和误诊。经导管PVL封堵术是外科手术高危患者的替代手段,可改善心力衰竭症状、降低死亡率,但该方法对溶血的临床研究较少,且术后可发生封堵器诱发的溶血加重。本文就外科瓣膜置换术后PVL相关性溶血的机制和介入治疗进展予以系统综述。

Paravalvular leak(PVL)is one of the most common complications after surgical valve replacement.The clinical manifestations are cardiac insufficiency and/or hemolysis.In comparison,hemolysis mostly occurs after mechanical metal valve replacement,with a relatively low incidence and easy to be ignored and misdiagnosed.Transcatheter closure of PVL is an alternative method for surgical high-risk patients,which can improve cardiac function and reduce mortality.However,there are few clinical studies on hemolysis,and hemolysis induced by occluder can occur after operation.This article reviews the mechanism of PVL hemolysis after surgical valve replacement and progress of interventional therapy.