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3D打印技术在经导管主动脉瓣置换术治疗二叶式主动脉瓣狭窄中的应用

Application of 3D printing technology in transcatheter aortic valve replacement for bicuspid aortic stenosis
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摘要 目的探讨3D打印技术在经导管主动脉瓣置换术(TAVR)治疗二叶式主动脉瓣狭窄中的应用价值。方法回顾性分析2020年1月至2023年1月于河北医科大学第二医院心脏外科行TAVR治疗的二叶式主动脉瓣狭窄患者的临床资料。根据是否应用3D打印技术将患者分为3D打印组和非3D打印组,比较2组患者围手术期的各项临床指标。结果共纳入患者70例,其中3D打印组35例,非3D打印组35例。患者术后不适症状均较术前明显改善,术后左室射血分数均有不同程度的提升。与非3D打印组相比,3D打印组手术时间、X线照射时间、跨瓣时间明显缩短,术后“瓣中瓣”置入、传导阻滞的发生概率明显降低,差异均有统计学意义(P均<0.05);2组术后中量及以上瓣周漏、瓣膜移位、中转开胸发生率比较,差异无统计学意义(P>0.05)。结论3D打印技术可有效指导二叶式主动脉瓣狭窄的TAVR治疗,在明显缩短手术时间的同时可有效提高TAVR手术的成功率,降低不良事件的发生风险,为二叶式主动脉瓣狭窄的经导管治疗提供了新思路。 Objective To explore the value of 3D printing technology in transcatheter aortic valve replacement(TAVR)for bicuspid aortic stenosis.Methods We retrospectively analyzed the clinical data of patients who underwent TAVR for bicuspid aortic stenosis at the Department of Cardiac Surgery of the Second Hospital of Hebei Medical University between January 2020 and January 2023.Seventy patients were divided into 3D printing and non-3D printing groups of 35 each,based on whether or not 3D printing technology was applied,and the perioperative clinical data of the two groups were compared.Results The patients’postoperative symptoms significantly improved compared with those before the operation,and the left ventricular ejection fraction increased to varying degrees.Compared with the non-3D printing group,the operation time,X-ray irradiation time.and transvalvular time in the 3D printing group were significantly shortened,and the probabilities of the occurrence of postoperative“flap-to-flap”implantation and conduction block were significantly reduced,with statistically significant differences(P<0.05).There was no statistically significant difference(P>0.05)in the incidence of moderate and above perivalvular leakage,valve displacement,or conversion to thoracotomy between the two groups after surgery.Conclusion 3D printing technology can effectively guide the TAVR treatment of bicuspid aortic stenosis.While significantly shortening the operation time,it can effectively increase the success rate of TAVR and reduce the risk of adverse events,providing a new approach for the transcatheter treatment of bicuspid aortic stenosis.
作者 张航 王华君 石凤梧 刘苏 马千里 安景辉 ZHANG Hang;WANG Huajun;SHI Fengwu;LIU Su;MA Qianli;AN Jinghui(Department of Cardiac Surgery,The Second Hospital of Hebei Medical University,Shijiazhuang 050061,China)
出处 《中国医科大学学报》 北大核心 2025年第10期942-945,957,共5页 Journal of China Medical University
基金 河北省医学科学研究课题(20240023)。
关键词 3D打印 经导管主动脉瓣置换术 二叶式主动脉瓣 3D printing transcatheter aortic valve replacement bicuspid aortic stenosis
作者简介 张航(1993-),男,主治医生,硕士;通信作者:安景辉,E-mail:anjinghui2009@126.com。
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