经导管主动脉瓣置换术的应用研究进展

Research progress of application of transcatheter aortic valve replacement

我国心脏瓣膜病通常是由风湿性心脏病引起,然而,随着公共卫生条件的日益改善,风湿性疾病的患病率已大幅下降,瓣膜疾病现在大多由退行性病变引起,如退行性主动脉瓣狭窄。通过胸骨切开术进行开放式外科瓣膜置换虽然提供了良好的临床预后,但该治疗方法仍存在较高的手术风险。经导管主动脉瓣置换术(TAVR)是治疗严重主动脉瓣狭窄的一种微创方法,由于其优点众多,成为了中高危瓣膜疾病患者的首选治疗方法。这项新技术目前受到了心血管领域高度关注,引领了微创心脏经皮介入术的新革命。本文对TAVR的技术简介、临床应用及远期效果进行综述。

Valvular heart disease in China is usually caused by rheumatic heart disease.However,with increasingly improved public health conditions,the prevalence of rheumatic diseases has decreased substantially,and valvular diseases are now mostly caused by degenerative lesions,such as degenerative aortic stenosis.Although open surgical valve replacement via sternotomy provides a good clinical prognosis,this treatment method still carries a high surgical risk.Transcatheter aortic valve replacement(TAVR)is a minimally invasive method for the treatment of severe aortic stenosis.Because of its many advantages,it has become the first choice for patients with middle-to high-risk valve disease.At present,this new technology has attracted great attention in the cardiovascular field,leading to a new revolution in minimally invasive percutaneous cardiac intervention.This article reviews the technical introduction,clinical application and long-term effects of TAVR.