3D打印技术应用于经导管主动脉瓣置换术前冠状动脉阻塞风险评估1例

Application of 3D printing in the risk assessment of coronary artery obstruction before transcatheter aortic valve replacement:a case report

冠状动脉阻塞是经导管主动脉瓣置换术(transcatheter aortic valve replacement, TAVR)少见却致命的并发症,然而尚无公认的标准方案应用于此并发症的风险评估。目前,针对TAVR冠状动脉阻塞风险评估最常用的方法是通过影像学直接评估,但是瓣膜部署后钙化团块的真实偏转情况很难被精确预测。因此,该风险评估可能受到经验主义的影响,从而导致评估结果出现偏差。本文报道TAVR术前应用3D打印技术精确评估冠状动脉阻塞风险1例,为临床诊治提供经验参考。

Coronary artery obstruction is a rare but fatal complication of transcatheter aortic valve replacement(TAVR).Experts have summarized and approved the related prevention strategies,yet there are no accepted criteria to evaluate the occurrence of coronary artery obstruction accurately.The most common method for the risk assessment of coronary artery obstruction before TAVR is direct imaging assessment.However,the actual deflection of the calcium deposits towards the coronary ostia during valve deployment is difficult to predict precisely.Therefore,the risk assessment may be influenced by empiricism,which may lead to a biased result.This paper reports a case of accurate evaluation of coronary artery obstruction risk by 3D printing before TAVR,providing a reference for clinical diagnosis and treatment strategy in similar cases.