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Venus-P瓣膜置换术治疗中重度肺动脉瓣反流合并右心室收缩功能不全患者近期疗效
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作者 谢海月 朱文浩 +1 位作者 夏智渊 张戈军 《浙江大学学报(医学版)》 北大核心 2025年第3期390-398,共9页
目的:评估Venus-P瓣膜经导管肺动脉瓣置换术(TPVR)治疗复杂先天性心脏病术后中重度肺动脉瓣反流合并右心室收缩功能不全患者的近期疗效。方法:回顾性纳入2014年2月至2024年2月于阜外医院接受Venus-P瓣膜TPVR治疗(28例)或外科肺动脉瓣置... 目的:评估Venus-P瓣膜经导管肺动脉瓣置换术(TPVR)治疗复杂先天性心脏病术后中重度肺动脉瓣反流合并右心室收缩功能不全患者的近期疗效。方法:回顾性纳入2014年2月至2024年2月于阜外医院接受Venus-P瓣膜TPVR治疗(28例)或外科肺动脉瓣置换术(SPVR)治疗(19例)的患者。所有患者术前均存在中重度肺动脉瓣反流且右心室射血分数小于45%。评估患者出院时及随访期间(随访至术后6个月)肺动脉瓣功能和心室功能的变化,并比较两种术式的疗效差异。结果:所有患者均顺利完成手术,术后无早期死亡。术后6个月,TPVR组肺动脉瓣跨瓣压差低于SPVR组(P<0.05)。两组患者的纽约心脏协会心功能分级、双心室射血分数及右心室舒张末期容积指数较术前均改善(均P<0.05)。术后右心室舒张末期横径改善幅度在两组间存在显著差异(P<0.01),多变量分析结果提示该差异与术式无关(β=4.4,P>0.05)。TPVR组术后QRS时限缩短(P<0.01),左心室舒张末期容积指数及心脏指数亦有改善(均P<0.01),但改善幅度与SPVR组差异无统计学意义(均P>0.05)。随访期间,两组各有1例患者术后1个月发生感染性心内膜炎,经抗感染治疗痊愈,未见其他严重并发症。结论:对于中重度肺动脉瓣反流合并右心室收缩功能不全患者,Venus-P瓣膜TPVR可有效改善短期肺动脉瓣功能及心室功能,且安全性良好,具有成为SPVR微创替代方案的潜力。 展开更多
关键词 肺动脉瓣反流 右心室收缩功能不全 经导管肺动脉瓣置换术 venus-p瓣膜 疗效 回顾性研究
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Outcomes of Self-Expanding Transcatheter Pulmonary Valves:Extended Follow-Up of a Prospective Trial
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作者 Jingnan Zhang Junyi Wan +6 位作者 Yihang Li Yu Han Jiahua Pan Fang Fang Shiliang Jiang Xiangbin Pan Gejun Zhang 《Congenital Heart Disease》 SCIE 2023年第2期219-234,共16页
Background:The Venus-P valve was the first self-expanding valve used world-wide for transcatheter pulmonary valve replacement(TPVR)in patients with severe pulmonary regurgitation(PR).We intended to report the extended... Background:The Venus-P valve was the first self-expanding valve used world-wide for transcatheter pulmonary valve replacement(TPVR)in patients with severe pulmonary regurgitation(PR).We intended to report the extended follow-up results from the prospective trial(No.NCT02590679).Methods:A total of 38 patients with severe PR(mean age 24.2±13.2)were included.Follow-up data were obtained after implanted at 1,6,and 12 months and yearly after.The frame geometry was assessed on post-implant computer tomography(CT)scanning by calculating the non-circularity[circularity ratio(minimum diameter/maximum diameter)<0.9]and under-expansion[expansion ratio(derived external valve area/nominal external valve area)<0.9).Adverse events(all-cause mortality,reintervention,valve dysfunction,stent fracture and endocarditis)were recorded.Results:All valves were implanted successfully with normal function at discharge.Geometric CT analysis showed underexpanded valve was detected in 22 patients(63%)and non-circular valve was seen in 16 patients(46%).During a median follow-up of 4.8 years(range 0.3-8.1),there were 1 death and 1 surgical explant,both resulting from endocarditis.Five-year freedom from valve dysfunction and stent fracture were 84.8%(95%CI 74.8-94.7)and 83.5%(95%CI 73.8-93.2).Endocarditis occurred in 3 patients at a median time of 7 months.Stent fracture was more common in patients with non-circularity stents.Conclusion:TPVR using Venus-P valve is associated with favorable outcomes at 5 years.Non-circular shapes in the valve level may have a higher risk of stent fracture. 展开更多
关键词 Congenital heart disease pulmonary regurgitation transcatheter pulmonary valve replacement venus-p valve
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