中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (53): 10017-10020.doi: 10.3969/j.issn.1673-8225.2010.53.033

• 器官移植学术探讨 academic discussion of organ transplantation • 上一篇    下一篇

经皮主动脉瓣置换的最新研究进展　　

廖  然，程应樟　   

  1. 南昌大学第二附属医院心内科，江西省南昌市 330006
  • 出版日期:2010-12-31 发布日期:2010-12-31
  • 通讯作者: 程应樟，主任医师，教授，硕士生导师，南昌大学第二附属医院心内科，江西省南昌市 330006 Cyz_6606@126.com
  • 作者简介:廖然★，男，1987年生，江西省临川市人，汉族，南昌大学在读硕士，主要从事先天性心脏病介入治疗研究。

Progress of percutaneous aortic valve replacement

Liao Ran, Cheng Ying-zhang   

  1. Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang  330006, Jiangxi Province, China
  • Online:2010-12-31 Published:2010-12-31
  • Contact: Cheng Ying-zhang, Chief physician, Professor, Master’s supervisor, Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China Cyz_6606@126.com
  • About author:Liao Ran★, Studying for master’s degree, Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China

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摘要：

背景：外科手术是主动脉瓣狭窄的主要治疗方法，但是对于高龄、多重合并症及高手术风险的患者，经皮主动脉瓣置换是最好的选择。
目的：总结经皮主动脉瓣置换在在心血管疾病中的应用进展。
方法：由第一作者检索2000/2010 PubMed数据(http://www.ncbi.nlm.nih.gov/PubMed)及万方数据库(http://www. wanfangdata.com.cn)有关主动脉瓣狭窄外科手术治疗、药物治疗及介入治疗等方面的文献，英文检索词为“arotic stenosis，percutaneous aortic valve replacement，valve stent”，中文检索词为“主动脉瓣狭窄；经皮主动脉瓣置换；瓣膜支架；器官移植”。排除重复性研究。计算机初检得到63篇文献，根据纳入标准保留25篇进一步归纳总结。
结果与结论：自2002年首例在人体实施经皮主动脉瓣置换手术后，近8年得到了极大的发展，不论是新的心脏瓣膜开发还是手术方式的改善都发展的相当迅速。但是就目前的技术而言还有很多缺陷，比如瓣膜支架不能很好地固定导致瓣膜移位和瓣周漏，血栓形成及主动脉瓣关闭不全也有一定的风险，并且手术操作较复杂在全球范围内普及较低，在中国进行的手术例数更是屈指可数。相信随着手术技术的改良和瓣膜支架的开发以及对手术的更深入研究，经皮主动脉瓣膜置换必将得到更好的发展，使得更多的患者能够获得很好治疗。

关键词: 主动脉瓣狭窄, 经皮主动脉瓣置换, 瓣膜支架, 器官移植, 综述文献

Abstract:

BACKGROUND: Surgical aortic valve replacement is the primary treatment of aortic stenosis. However, percutaneous aortic valve replacement is preferred for patients with old age, multiple co-morbidities and high operative risks.
OBJECTIVE: To summarize the application progress of pervutaneous aortic valve replacement in the treatment of cardiovascular diseases.
METHODS: The databases of PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang (http://www.wanfangdata.com.cn) were retrieved by the first author using key words of “aortic stenosis, percutaneous aortic valve replacement and valve stent”. Repetitive studies were excluded. Totally 63 documents were initially searched, and 25 literatures were included in the further analysis.
RESULTS AND CONCLUSION: Since the first percutaneous aortic valve replacement in 2002, valve stents and procedural approaches have got an unprecedented development. However, there are many defects in percutaneous aortic valve replacement, such as valve displacement or perivalvular leakage resulted from poor fixation of valve matrix, thrombosis, aortic insufficiency, and low popular rate. With the improvement of surgical methods and valve development, percutaneous aortic valve replacement would be a good method for patients with aortic stenosis.

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