计算机断层扫描指导经皮主动脉瓣膜置换术导丝过瓣可行性研究

Wire crossing the aortic valve during transcatheter aortic valve implantation guided by the projection determined from the computed tomography analysis

目的探讨运用计算机断层扫描(CT)分析获得的最佳投照角度指导经皮主动脉瓣膜置换术(TAVI)术中导丝过瓣的可行性。方法选取自2016年5月至2020年6月于北部战区总医院心血管内科行TAVI且手术过程被完整录制的32例患者为研究对象。根据患者是否接受CT指导分析,将其分为常规组(n=19)与CT指导组(n=13)。比较两组患者过瓣时间。结果所有患者中,过瓣时间最长为461.0 s,最短为1.0 s,中位时间27.5 s。过瓣时间>5 min者有3例,均发生在常规组。应用CT指导导丝过瓣时间最长为62.0 s。CT指导组过瓣时间短于常规组,差异有统计学意义(P<0.05)。结论术前CT分析对于TAVI术中导丝过瓣有良好的指导作用,能缩短过瓣时间。

Objective To investigate the feasibility of wire crossing aortic valve during transcatheter aortic valve implantation(TAVI)guided by the optimal projection(OP)determined from computed tomography(CT)analysis.Methods A retrospective study was performed on 32 patients who underwent TAVI and whose surgical procedures were completely recorded from May 2016 to June 2020.Patients were divided into the conventional group(n=19)and the CT guided group(n=13)according to whether they had received CT guidance analysis.The time of crossing aortic valve was compared between the two groups.Results In all patients,the longest valvular time was 461 seconds,the shortest was 1 second,and the median time was 27.5 seconds.There were 3 cases with the time more than 5 minutes,all of which occurred in the conventional group.The longest running time of wire crossing guided by CT were 62 seconds.The time of crossing valve in CT guided group was shorter than that in conventional group,and the difference was statistically significant(P<0.05).Conclusion Preoperative CT analysis has a good guiding role for the crossing wire in TAVI operation,and can shorten the wire crossing valve time.