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如何预测经导管主动脉瓣置换术后的传导障碍。

How to predict conduction disturbances after transcatheter aortic valve replacement.

作者信息

Novelli Laura, Jamie Gulrays, Regazzoli Damiano, Reimers Bernhard, Frontera Antonio, Mangieri Antonio

机构信息

Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy.

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy.

出版信息

Kardiol Pol. 2023;81(4):330-337. doi: 10.33963/KP.a2023.0039. Epub 2023 Feb 6.

Abstract

Transcatheter aortic valve replacement (TAVI) has evolved into the gold standard management option for high-risk patients with severe aortic stenosis. Despite identifying procedural, electrocardiographic, and clinical predictors of important post-procedural conduction disturbances (left bundle branch block and high-degree atrioventricular block) and despite continuous technological refinement of transcatheter aortic valves, the rate of post-procedural conduction disturbance remains high and challenging to manage. New strategies are required to reduce the overall rate of post-procedural permanent pacemaker implantations. In this article, we will review the incidence, predictive factors, and clinical implications of conduction disturbances after TAVI.

摘要

经导管主动脉瓣置换术(TAVI)已发展成为重度主动脉瓣狭窄高危患者的金标准治疗选择。尽管已确定了术后重要传导障碍(左束支传导阻滞和高度房室传导阻滞)的手术、心电图及临床预测因素,且经导管主动脉瓣的技术不断改进,但术后传导障碍的发生率仍然很高,且管理颇具挑战性。需要新的策略来降低术后永久性起搏器植入的总体发生率。在本文中,我们将综述TAVI术后传导障碍的发生率、预测因素及临床意义。

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