Chimney支架技术联合All in One技术在经导管主动脉瓣置换术中应用的初步经验

Feasibility and Efficacy of Chimney Stenting Combined With All in One Technique During Transcatheter Aortic Valve Replacement

目的:总结Chimney支架技术联合All in One技术在经导管主动脉瓣置换术(TAVR)中应用的初步经验。方法:收集2021年7月至2022年7月首都医科大学附属北京安贞医院心脏瓣膜病介入中心在TAVR术中联合应用Chimney支架技术和All in One技术的10例患者进行回顾性分析,总结临床资料、影像学资料、手术操作、住院和出院随访期间主要不良心脑血管事件的发生情况。结果:10例患者中男性4例,女性6例,平均年龄(76.2±3.9)岁,三叶式主动脉瓣7例,二叶式主动脉瓣3例,术前CT评估均有冠状动脉阻塞危险因素,并且术中球囊预扩张提示冠状动脉阻塞。所有患者均使用一枚药物洗脱支架完成Chimney支架技术,冠状动脉支架置入有8例位于左主干,2例位于右冠状动脉,支架平均直径(3.7±0.3)mm,平均长度(20.6±2.4)mm,在住院及平均随访(7.8±3.7)个月期间,无死亡、心肌梗死、脑卒中等主要不良心脑血管事件发生。结论:TAVR术中Chimney支架技术联合All in One技术安全可行。

Objectives:To summarize the efficacy and initial experience of chimney stenting combined with All in One technique during transcatheter aortic valve replacement(TAVR).Methods:Ten patients who underwent chimney stenting combined with All in One technique during TAVR between July 2021 and July 2022 at the Interventional Center of Valvular Heart Disease of Beijing Anzhen Hospital were enrolled in this retrospective analysis.The clinical data,imaging records,and the occurrence of major adverse cardiac events during hospitalization and follow-up were analyzed.Results:Procedure was successful in all 10 patients.There were 4 males and 6 females in this patient cohort.7 patients had tricuspid aortic valves and 3 had bicuspid aortic valves.Preoperative CT angiography showed that all patients had risk factors for coronary artery obstruction and coronary artery obstruction was indicated during intraoperative balloon predilation.The left main coronary artery was stented in 8 cases and the right coronary artery in 2 cases,the mean diameter of the stents was(3.7±0.3)mm and the mean length was(20.6±2.4)mm.There were no major adverse cardiac events such as death,myocardial infarction,or stroke during hospitalization and a mean follow-up period of(7.8±3.7)months.Conclusions:Chimney stenting combined with All in One technique in TAVR is safe and feasible.