经导管主动脉瓣置入术围手术期新发心脏传导阻滞结果分析

A clinical report of conduction disturbances after transcatheter aortic valve implantation

目的分析经导管主动脉瓣置入术(TAVI)不同人工瓣膜围手术期新发传导阻滞及永久起搏器置入的发生率。方法收集2018年1月至2019年7月在首都医科大学附属北京安贞医院心脏外科瓣膜中心行TAVI治疗的97例重度主动脉瓣狭窄或重度主动脉瓣关闭不全患者的临床资料。分为经股动脉途径Venus-A瓣膜组(52例)与经心尖途径J-Valve瓣膜组(45例)。比较两组患者围手术期传导阻滞及永久起搏器置入的发生率。结果Venus-A瓣膜组与J-Valve瓣膜组比较,新发传导阻滞[48.1%(25/52)对53.3%(24/45),P=0.61]及永久起搏器置入[11.5%(6/52)对6.7%(3/45),P=0.50]差异无统计学意义。J-Valve瓣膜组中的主动脉瓣狭窄亚组与主动脉瓣关闭不全亚组比较,患者新发传导阻滞[43.8%(7/16)对58.6%(17/29),P=0.34]及永久起搏器置入[6.3%(1/16)对6.9%(2/29),P=1.00]差异无统计学意义。结论应用Venus-A瓣膜与J-Valve瓣膜行TAVI治疗的患者,围手术期传导阻滞及永久起搏器置入的发生率差异无统计学意义。

Objective To compare the effect of different transcatheter valve types on conduction disturbances after transcatheter aortic valve implantation.Methods From January 2018 to July 2019,97 patients with valvular heart disease were treated by transcatheter aortic valve implantation(TAVI)at Beijing Anzhen Hospital,Capital Medical University.According to the transcatheter valve type,patients were divided into Venus-A group(52 cases)and J-Valve group(45 cases).Incidences of conduction disturbances and permanent pacemaker implantation events were analyzed.Results There was no significant difference of the incidence of conduction disturbances and permanent pacemaker implantation events between Venus-A group and J-Valve group[48.1%(25/52)vs.53.3%(24/45),11.5%(6/52)vs.6.7%(3/45)](P=0.61,0.50).There was also no significant difference between aortic stenosis and aortic regurgitation in J-Valve group[43.8%(7/16)vs.58.6%(17/29),6.3%(1/16)vs.6.9%(2/29)](P=0.34,1.00).Conclusion There is no significant difference between Venus-A group and J-Valve group on the incidence of conduction disturbances and permanent pacemaker implantation.