经导管主动脉瓣置换术中人工瓣膜连合对齐技术的研究进展及应用

Current status,research progress and application of commissural alignment in transcatheter aortic valve replacement

经导管主动脉瓣置换术的适应证已向低龄、低危患者扩展,因此术后冠状动脉(下称冠脉)介入问题显得尤为重要。越来越多的研究证据表明,连合对齐对于术后冠脉通路、血流动力学、再次手术等有着重要影响。目前的研究已实现部分自膨胀瓣膜的连合对齐。同时瓣膜连合对齐是未来瓣膜以及输送系统设计的重要发展方向。本文就经导管主动脉瓣置换术中人工瓣膜连合对齐技术的研究进展作一述评,包括瓣膜连合对齐的定义、意义、实现方法和未来的发展方向。

As the indications for transcatheter aortic valve replacement expanded to lower risk and younger patients,the problem of postoperative coronary artery intervention becomes particularly important.A growing body of research evidence that commissural alignment impacts coronary access,hemodynamics and reoperation.Recent studies have provided modified delivery system insertion and rotation techniques to obtain commissural alignment with certain self-expanding valves.At the same time,commissural alignment will be an important direction of future valve and delivery system design.The aim of this review is to summarize the research progress of valve commissure alignment,including the definitions,significance,technical steps and future directions.