经皮主动脉瓣置换的新进展

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3　小结

PAVR在动物试验和初步临床应用中已经取得了较满意的效果,但是目前仍有许多问题有待解决。主动脉根部解剖复杂、手术操作困难、瓣膜支架定位不准确和固定操作均可引起心肌梗死和心包压塞等严重的并发症^{[ 14 ]} 。目前技术还不能使置入的支架瓣膜与自体主动脉完全贴壁,瓣膜移位和瓣周漏不可避免;血栓栓塞、支架寿命有限均存在潜在的风险。目前置入人工瓣膜支架采用球囊扩张置入方式,需要24F导管,增加了手术难度和血管损伤;现在植入途径多采用前向途径,操作复杂;手术置入过程中的影像学引导需要更为准确的引导技术;术中的远端保护防止自然瓣膜碎
片脱落造成的栓塞等等问题。但是随着材料学的进步和介入心脏病学经验的不断丰富和积累,现有的一些技术难题会不断攻克解决,为主动脉瓣疾病介入治疗的发展提供良好的技术支持^{[ 15, 16 ]} ,使主动脉瓣患者从新的治疗方法中获得更大的利益。

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来源：心血管病学进展作者：赵建峰，祁国奇

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