中国临床医学影像杂志2025，Vol.36Issue(9)：630-634,5.DOI:10.12117/jccmi.2025.09.006
主动脉瓣狭窄合并冠心病患者经皮冠状动脉介入联合经导管主动脉瓣置换的超声心动图随访研究
Percutaneous coronary intervention and transcatheter aortic valve replacement for aortic valve stenosis and coronary heart disease:echocardiograph follow-up analysis
摘要
Abstract
Objective:To analyze the treatment and follow-up experience of percutaneous coronary intervention(PCI)combined with transcatheter aortic valve replacement(TAVR)for patients with aortic valve stenosis(AS)complicated by coronary artery disease(CHD).Methods:A retrospective study was conducted on 69 patients who underwent PCI combined with TAVR surgery at Henan Provincial Chest Hospital from January 2020 to April 2023,including 39 males(56.5%)and 30 females(43.5%),with an average age of(71.8±6.0)years.We collected baseline data,perioperative and long-term complications,and echocardiographic results during hospitalization and follow-up.We compared changes in echocardiographic parameters(Vmax,PGmean,LVEDD,and LVEF)between preoperative and follow-up periods.Results:All patients underwent successful PCI combined with TAVR without any intermediate transfer to surgery or perioperative mortality.One patient had moderate paravalvular leakage during surgery,but a second valve(valve-in-valve)was successfully implanted.Another patient developed moderate paravalvular leakage after surgery.However,no patients experienced severe paravalvular leakage or valve displacement.Two cases of femoral artery pseudoaneurysm and one case of femoral arteriovenous fistula were observed,but without severe vascular complications.One patient had a transient ischemic attack after surgery,and recovered after treatment.Two patients developed new-onset severe atrioventricular block and underwent permanent pacemaker implantation.During follow-up,one patient died of hemorrhagic stroke one month after surgery.Five patients were hospitalized for pulmonary infections,resulting in two deaths.One patient experienced a transient ischemic attack six months after surgery but recovered spontaneously.Two patients had moderate to severe paravalvular leakage due to valve migration,but a second valve(valve-in-valve)was successfully implanted.One patient required hospitalization for gastrointestinal bleeding.Comparison with preoperative echocardiographic results,Vmax and PGmean significantly decreased on 1 day after operation(P＜0.001),LVEDD started to significantly decrease at 1 month after operation(P＜0.05),and LVEF began to significantly increase at 3 month after operation(P＜0.05).Conclusion:PCI combined with TAVR is a safe and effective treatment for patients with AS complicated by CHD.The echocardiography plays an important role in both treatment and follow-up.关键词
主动脉瓣狭窄/冠心病/经导管主动脉瓣置换/超声心动描记术Key words
Aortic Valve Stenosis/Coronary Disease/Transcatheter Aortic Valve Replacement/Echocardiography分类
医药卫生引用本文复制引用
李萌萌,纪淑姣,袁义强..主动脉瓣狭窄合并冠心病患者经皮冠状动脉介入联合经导管主动脉瓣置换的超声心动图随访研究[J].中国临床医学影像杂志,2025,36(9):630-634,5.基金项目
河南省医学科技攻关计划项目(2018020540). （2018020540）
