经导管主动脉瓣置换术对功能性二尖瓣关闭不全的影响
Effect of transcatheter aortic valve replacement on functional mitral regurgitation
冯晔子 1杨倩 1马倩倩 1翟同宁 1程帅 1袁义强 2张申伟1
作者信息
- 1. 郑州市第七人民医院(郑州市心血管病医院)心内科(郑州,450000)
- 2. 河南省胸科医院
- 折叠
摘要
目的:分析主动脉瓣重度狭窄合并功能性二尖瓣关闭不全的患者经导管主动脉瓣膜置换术(TAVR)后对二尖瓣关闭不全的影响.方法:回顾性统计分析从2017年9月-2021年12月我院收治的主动脉瓣重度狭窄合并功能性二尖瓣关闭不全接受TAVR的40例患者,在接受TAVR后6个月二尖瓣关闭不全、心脏超声数据的变化.结果:主动脉瓣跨瓣峰流速、主动脉跨瓣峰压差、左房横径、左房前后径、左室射血分数、二尖瓣关闭不全的情况在术后1周时与术前相比差异有统计学意义,这些差异在术后6个月时仍持续存在;左室舒张末期直径在术后6个月与术前相比差异有统计学意义;二尖瓣关闭不全的情况术后6个月时与术后1周比较差异有统计学意义.结论:主动脉瓣重度狭窄合并功能性二尖瓣关闭不全的患者在TAVR后,二尖瓣关闭不全的情况在围术期即会出现明显改善,且在6个月时会进一步改善.对于主动脉瓣重度狭窄合并功能性二尖瓣关闭不全的患者可以先进行TAVR手术解决主动脉瓣的重度狭窄,然后再定期评估二尖瓣关闭不全的情况,决定是否进一步处理二尖瓣病变.
Abstract
Objective:This study sought to analyze the effect of transcatheter aortic valve replacement on func-tional mitral regurgitation in patients with severe aortic stenosis and mitral regurgitation.Methods:A total of 40 patients with severe aortic stenosis and mitral regurgitation were enrolled who received transcatheter aortic valve replacement in our hospital from September 2017 to December 2021.The changes of mitral regurgitation and car-diac ultrasound data at 6 months after transcatheter aortic valve replacement were analyzed.Results:There were statistically significant differences in aortic valve peak velocity,aortic valve peak gradient,left atrial transverse di-ameter,left atrium anteroposterior diameter,left ventricular ejection fraction and mitral regurgitation at 1 week after TAVR,and these differences still existed 6 months after TAVR.Compared with before TAVR,the differ-ence of left ventricular end diastolic dimension was statistically significant at 6 months after TAVR.The mitral in-sufficiency was a statistically significant difference between 6 months after TAVR and 1 week after TAVR.Con-clusion:Functional mitral regurgitation in patients with severe aortic stenosis and mitral regurgitation was signifi-cantly improved perioperative and further improved at 6 months after TAVR.Patients with severe aortic stenosis combined with functional mitral regurgitation can undergo TAVR,and then periodically evaluate mitral regurgita-tion to determine whether to further manage mitral regurgitation.
关键词
经导管主动脉瓣置换术/主动脉瓣重度狭窄/二尖瓣关闭不全Key words
transcatheter aortic valve replacement/severe aortic stenosis/mitral regurgitation引用本文复制引用
基金项目
河南省医学科技攻关计划(LHGJ20210754)
河南省医学科技攻关计划联合共建项目(LHGJ20191114)
出版年
2024
NETL
NSTL
万方数据