经导管主动脉瓣置换术后肺动脉压力的变化

目的应用超声心动图评估重度主动脉瓣狭窄患者经导管主动脉瓣置换(TAVI)术后肺动脉压力(PASP)的变化。方法入选94例重度主动脉瓣狭窄患者,均成功完成TAVI手术。根据术前PASP分为两组,无肺动脉高压组(PASP<40mmHg)和肺动脉高压组(PASP≥40mmHg)。结果TAVI术后,无肺动脉高压组和肺动脉高压组PASP均降低。肺动脉高压组具有更小的主动脉瓣面积(0.58±0.16vs 0.67±0.16)cm^2,P=0.014],更高的主动脉瓣平均跨瓣压差(60.8±17.3vs 53.9±17.2)mmHg,P=0.035],中度以上二尖瓣反流(11.6vs 3.9)%,P<0.001]和中度以上三尖瓣反流(13.9vs 1.9)%,P<0.001]发生率更高。结论TAVI术后1年,肺动脉压力明显降低。

Changes in Pulmonary Artery Pressure After Transcatheter Aortic Valve Implantation Evaluated by Transthoracic Echocardiography

Objective Evaluate pulmonary hypertension(PH)after transcatheter aortic valve implantation(TAVI)by transthoracic echocardiography.Methods A total of 94 consecutive patients were included in this study.All patients were diagnosed with symptomatic severe aortic stenosis who underwent TAVI at Fuwai Hospital.Results After TAVI,PASP decreased in both PH group.Compared with no PH group,PH group:smaller valve effective orifice(0.58±0.16 vs 0.67±0.16)cm^2,P=0.014],higher mean transvalvular pressure gradient(60.8±17.3 vs53.9±17.2)mmHg,P=0.035],more moderate or severe mitral regurgitation(11.6 vs 3.9)%,P<0.001]and more moderate or severe tricuspid regurgitation(13.9 vs 1.9)%,P<0.001].Conclusions After TAVI,PASP decreased significantly.