经皮主动脉瓣置换术中的穿刺部位并发症：发生率、结局、预防及治疗
Access site complications in transcutaneous aortic valve replacement: frequency, outcomes, prevention, and treatment.
作者信息
Latham Samuel, Bob-Manuel Tamunoinemi, Sharma Arindam, Nanda Amit, Ardeshna Devareshi, Khouzam Rami N
机构信息
Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
出版信息
Ann Transl Med. 2018 Jan;6(1):14. doi: 10.21037/atm.2017.10.32.
Aortic stenosis (AS) is a common cause of valvular heart disease with heavy disease burden in elderly patients. It is present in almost 7% of patients older than 65. The mortality rate increases significantly once it becomes symptomatic with average life expectancy of around 1-year. Symptoms include angina, syncope, or heart failure. This requires either surgical or transcutaneous replacement. Transcutaneous aortic valve replacement (TAVR) use has increased in recent years from high risk patients to now even including intermediate risk patients. With the increased number of procedures performed, one of the consequences is access site complications. These complications can lead to increased hospitalization, cost, infections, and eventually worse outcomes. In this manuscript, we provide a comprehensive review discussing the consequences, outcomes, frequency, predictors and some possible solutions to these complications set forth in these studies.
主动脉瓣狭窄（AS）是老年患者瓣膜性心脏病的常见病因，疾病负担较重。在65岁以上的患者中，其发病率约为7%。一旦出现症状，死亡率会显著上升，平均预期寿命约为1年。症状包括心绞痛、晕厥或心力衰竭。这需要进行外科手术或经皮置换。近年来，经皮主动脉瓣置换术（TAVR）的应用范围已从高危患者扩大到现在甚至包括中危患者。随着手术数量的增加，后果之一是穿刺部位并发症。这些并发症会导致住院时间延长、费用增加、感染，最终导致更差的预后。在本手稿中，我们进行了全面综述，讨论了这些研究中提出的这些并发症的后果、结局、发生率、预测因素以及一些可能的解决方案。
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