经导管主动脉瓣置换术生物瓣膜与自体瓣膜对合技术的研究现状

Research status of commissural alignment between biological valve and autologous valve in transcatheter aortic valve replacement

经导管主动脉瓣置换术中生物瓣膜与自体瓣膜对合不佳会影响冠状动脉通路充盈,导致再次主动脉瓣介入治疗失败和瓣膜功能受损,影响患者远期预后。部分研究通过改变瓣膜释放前的轴向方向,应用个体化计算机模拟技术辅助改进对合技术,取得了一定成果。然而,瓣膜对合不佳对患者的影响仍存在许多未知的问题,瓣膜准确对合的技术仍需进一步探索。该文就目前经导管主动脉瓣置换术生物瓣膜与自体瓣膜对合不佳可能产生的影响、可能有效的瓣膜准确对合技术及相关研究进展进行系统性阐述。

Commissural misalignment of biological valve and autologous valve during transcatheter aortic valve replacement may affect the filling of coronary artery, reduce the feasibility of redo-aortic valve intervention and damage the valve function, which will adversely affect long-term prognosis of patients. Some studies have obtained achievement by changing the axial direction of valve and using individualized computer simulation technology to improve the alignment technology. However, there are still many unknown problems about the impact of commissural misalignment on patients,and accurate commissural alignment techniques still need to be further explored. This article systematically expounds the possible impact of commissural misalignment between biological valve and autologous valve in transcatheter aortic valve replacement, possibly effective accurate commissural alignment techniques and related research progress.