Tandar Anwar, Bull David A, Welt Frederick G P
Division of Cardiovascular Medicine, University of Utah School of Medicine, 30 North 1900 East, Rm 4A100, Salt Lake City, UT 84132 USA.
J Invasive Cardiol. 2017 Jan;29(1):E1-E7.
Paravalvular leak (PVL) following aortic valve implantation is a rare complication but may cause potentially serious consequences. It occurs in 2%-10% of surgical aortic valve replacements and 7%-17% of surgical mitral valve replacements. Transcatheter valve replacement data show that significant PVL occurs in 6%-8% of cases. The management of significant PVL has traditionally involved repeat surgical repair. However, many of these patients are considered too high risk to undergo a repeat surgical procedure; hence, a percutaneous transcatheter approach has often been utilized to treat these patients. Vascular plugs have been used to close PVLs, with variable results; the procedure is complex and technically demanding. Transcatheter aortic valve replacement, using a valve-in-valve approach, may provide an alternative approach for bioprosthetic PVL in the aortic position.
主动脉瓣植入术后瓣周漏（PVL）是一种罕见的并发症，但可能会导致潜在的严重后果。它在2% - 10%的外科主动脉瓣置换术中发生，在7% - 17%的外科二尖瓣置换术中出现。经导管瓣膜置换数据显示，6% - 8%的病例会出现严重的PVL。传统上，严重PVL的治疗方法是再次进行手术修复。然而，这些患者中的许多人被认为再次接受手术的风险过高；因此，经常采用经皮经导管方法来治疗这些患者。血管封堵器已被用于闭合PVL，但效果不一；该手术复杂且技术要求高。采用瓣中瓣方法的经导管主动脉瓣置换术可能为主动脉位置的生物人工瓣膜PVL提供一种替代方法。
