2025 年第 3 期 第 20 卷

自膨式Venus-A瓣膜与国产Renatus球囊扩张式介入瓣膜治疗重度主动脉瓣狭窄的临床效果比较

Comparison of the clinical effect of self-expanding Venus-A valve and domestic Renatus balloon expandable interventional valve in the treatment of severe aortic stenosis

作者：李亮1潘广瑞2房玲3

英文作者：Li Liang1 Pan Guangrui2 Fang Ling3

单位：1河北省邢台市人民医院心脏大血管外科，邢台054000；2河北省邯郸市中心医院心脏血管外科，邯郸056002；3华北医疗健康集团邢台总医院急诊科，邢台054000

英文单位：1Department of Cardiology and Macrovascular Surgery Xingtai People′s Hospital Hebei Province Xingtai 054000 China; 2Department of Heart and Vascular Surgery Handan Central Hospital Hebei Province Handan 056002 China; 3Department of Emergency Xingtai General Hospital of North China Medical and Health Group Hebei Province Xingtai 054000 China

关键词：重度主动脉瓣狭窄；自膨式Venus-A瓣膜；国产Renatus球囊扩张式介入瓣膜

英文关键词：Severeaorticstenosis;Self-expandingVenus-Avalve;DomesticRenatusballoonexpandableinterventionalvalve

• 摘要：

• 目的 比较自膨式Venus-A瓣膜与国产Renatus球囊扩张式介入瓣膜治疗重度主动脉瓣狭窄（AS）的临床效果。方法 选取2023年7月至2024年6月河北省邢台市人民医院收治的84例重度AS患者。根据患者实际情况为其制定手术方案并依此分组，其中采用自膨式Venus-A瓣膜治疗的44例患者为A组，采用国产Renatus球囊扩张式介入瓣膜治疗的40例患者为B组。比较2组患者手术指标及治疗效果。结果 A组与B组患者瓣膜置入成功率比较差异无统计学意义［97.7%（43/44）比100.0%（40/40）］（P＞0.05）；2组患者瓣膜滑脱、严重瓣周漏、球囊预扩张、股动脉入路、球囊后扩张、使用瓣中瓣比例以及手术时间比较差异均无统计学意义（均P＞0.05）。2组患者脑卒中、严重血管并发症发生率和30 d死亡率比较差异均无统计学意义（均P＞0.05），但B组植入心脏起搏器、主动脉瓣膜反流率低于A组［2.5%（1/40）比18.2%（8/44）、5.0%（2/40）比20.5%（9/44）］，差异均有统计学意义（均P＜0.05）。结论 自膨式Venus-A瓣膜与国产Renatus球囊扩张式介入瓣膜治疗重度AS均具有良好的治疗效果和预后，但自膨式Venus-A瓣膜置入术后的患者植入心脏起搏器、主动脉瓣膜反流的风险较国产Renatus球囊扩张式介入瓣膜置入术的患者更高。

• Objective  To compare the clinical effect of self-expanding Venus-A valve and domestic Renatus balloon expandable interventional valve in the treatment of severe aortic stenosis(AS). Methods A total of 84 patients with severe AS admitted to Xingtai People′s Hospital, Hebei Province from July 2023 to June 2024 were selected. According to the actual situation of patients, the operation plan was made and the patients were divided into two groups. Group A consisted of 44 patients treated with self-expanding Venus-A valve and group B consisted of 40 patients treated with domestic Renatus balloon expandable interventional valve. The surgical indicators and treatment effects of the two groups were compared.Results There was no significant difference in the success rate of valve implantation between group A and group B［97.7%(43/44) vs 100.0%(40/40)］(P>0.05). There were no significant differences in valve slippage, severe paravalvular leakage, balloon pre-dilation, femoral artery access, balloon post-dilation, proportion of valve within valve, and operation time between the two groups(all P>0.05). There were no significant differences in incidence rates of stroke, severe vascular complications, and 30-day mortality between the two groups(all P>0.05), but the rate of pacemaker implantation and aortic valve regurgitation in group B were lower than those in group A［2.5%（1/40） vs 18.2%（8/44）, 5.0%（2/40） vs 20.5%（9/44）］(both P<0.05). Conclusions  Both the self-expanding Venus-A valve and domestic Renatus balloon expandable interventional valve have good therapeutic effect and prognosis in the treatment of severe AS. However, the patients with self-expanding Venus-A valve implantation have a higher risk of pacemaker implantation and aortic regurgitation than those with domestic Renatus balloon expandable interventional valve implantation.