Dvir Danny, Barbash Israel M, Ben-Dor Itsik, Torguson Rebecca, Badr Salem, Minha Sa'ar, Pendyala Lakshmana K, Loh Joshua P, Pichard Augusto D, Waksman Ron
Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
Cardiovasc Revasc Med. 2013 May-Jun;14(3):174-81. doi: 10.1016/j.carrev.2013.02.003.
Paravalvular regurgitation is a common, potentially life-threatening complication of transcatheter aortic valve replacement. Previous studies report a 65%-94% rate of paravalvular leakage after transcatheter implantation, mostly of mild degree. The rate of significant (≥ +2) paravalvular regurgitation varies in large clinical trials, and is associated with worse clinical outcome. There is less agreement regarding the significance of mild regurgitation (grade 1+). There are anatomical and procedural correlates for paravalvular leak-most importantly, severe valve calcification, patient prosthetic mismatch, and device malposition. The following review details the current knowledge on paravalvular regurgitation after transcatheter aortic valve replacement, including diagnosis, correlates, clinical outcome, preventive and therapeutic strategies related to this complication.
瓣周反流是经导管主动脉瓣置换术常见的、可能危及生命的并发症。既往研究报告经导管植入术后瓣周漏发生率为65% - 94%，大多为轻度。在大型临床试验中，重度（≥ +2）瓣周反流的发生率各不相同，且与更差的临床结局相关。对于轻度反流（1+级）的意义，共识较少。瓣周漏存在解剖学和操作方面的相关因素，其中最重要的是严重瓣膜钙化、患者与人工瓣膜不匹配以及装置位置不当。以下综述详细介绍了经导管主动脉瓣置换术后瓣周反流的现有知识，包括诊断、相关因素、临床结局以及针对该并发症的预防和治疗策略。
