经导管主动脉瓣置换术风险及风险评估进展

Risk and Risk Assessment Progress of Transcatheter Aortic Valve Replacement

经导管主动脉瓣置换术(TAVR)是一种全新的微创瓣膜置换技术,其对于危重患者有重要意义。TAVR术后并发症少、成功率高、效果满意,其并发症发生率较低,手术效果均优于传统开胸手术。TAVR的常见并发症包括瓣周漏、房室传导阻滞、脑卒中及局部血管并发症,行TAVR时要谨慎对待,完善的术前准备(如术前风险评估、冠状动脉疾病筛查、血管通路筛查以及瓣环评估)对于提高手术效果、减少并发症发生以及改善患者预后有重大意义。但目前TAVR尚处于初始启动阶段,其并发症及预防方法尚需在实践中进一步了解,其瓣膜效果亦需在长期随访中继续观察。

Transcatheter aortic valve replacement(TAVR)is a new minimally invasive valve replacement technique,which is of great significance for critically ill patients.TAVR has less complications,high success rate and satisfactory effect,and its complication rate is low,and surgical effect is better than traditional thoracotomy.The common complications of TAVR include perivalvular leakage,atrioventricular block,stroke and local vascular complications.Due caution should be taken when performing TAVR,and perfect preoperative preparation(such as preoperative risk assessment,coronary artery disease screening,vascular pathway screening and valve ring evaluation)is of great significance to improve the surgery effect,reduce the occurrence of complications and improve the prognosis of the patients.However,TAVR is still in the initial staring stage,so its complications and prevention methods need to be further understood in practice,and its valve effect also needs to be continuously observed during long-term follow-up.