二次经导管主动脉瓣置换术在结构性生物瓣膜退化中的临床研究现状和进展

Clinical research status and progress of redo-transcatheter aortic valve replacement for structural biovalvular degeneration

生物瓣膜会随时间的推移及各种因素影响导致结构性瓣膜退化(structural valve degeneration,SVD),降低其耐久性。SVD患者需要再次行瓣膜置换术,而传统外科开胸手术创伤大,患者常因不能耐受而放弃治疗。研究显示,作为再次外科开胸瓣膜置换手术的替代治疗方案,二次经导管主动脉瓣置换术治疗SVD安全、有效,但仍然面临较多挑战,包括人工瓣膜-患者不匹配、高跨瓣压差、冠状动脉阻塞等。该文旨在对SVD患者实施二次经导管主动脉瓣置换术的策略、临床研究现状和进展进行综述。

Biological valves can lead to structural valve degeneration(SVD)over time and due to various factors,reducing their durability.SVD patients need to undergo valve replacement surgery again,while traditional open chest surgery can cause significant trauma and patients often give up treatment due to intolerance.Research has shown that as an alternative treatment option for reoperation of thoracic valve replacement surgery,redo-transcatheter aortic valve replacement for SVD is safe and effective,but still faces many challenges,including prosthesis-patient mismatch,high cross valve pressure difference,and coronary obstruction.This article aims to review the strategies,clinical research status and progress of redo-transcatheter aortic valve replacement in SVD patients.