2025 年第 10 期 第 20 卷

小主动脉瓣环的外科治疗进展

Advances in surgical treatment of small aortic annulus

作者：董成新1杨思远2刘昆2

英文作者：Dong Chengxin1 Yang Siyuan2 Liu Kun2

单位：1贵州医科大学附属医院心脏大血管外科，贵阳550001；2贵州医科大学临床医学院外科教研室，贵阳550001 董成新为贵州医科大学2023级研究生

英文单位：1Department of Cardiac and Great Vessel Surgery The Affiliated Hospital of Guizhou Medical University Guiyang 550001 China; 2Department of Surgery Teaching and Research Section Clinical Medical College Guizhou Medical University Guiyang 550001 China Dong Chengxin is a 2023 Graduate Student at Guizhou Medical University

关键词：小主动脉瓣环；瓣膜-患者错配；主动脉瓣置换术；治疗策略；新技术

英文关键词：Smallaorticannulus;Patient-prosthesismismatch;Aorticvalvereplacement;Therapeuticstrategy;Newtechnology

• 摘要：

• 主动脉病变的诊疗一直是心血管领域研究的重点，其中小主动脉瓣环给主动脉疾病的治疗带来极大挑战，与患者不良预后密切相关。目前国内外对小主动脉瓣环的外科治疗方式的选择尚无统一的观点。针对这一类特殊群体，现有的治疗手段包括主动脉根部扩大、经导管主动脉瓣置换术、无支架生物瓣膜、免主动脉瓣膜和新技术等已得到一定发展，以改善瓣膜血流动力学和临床结局。但是治疗方式和瓣膜的选择上存在争论，新技术的应用也缺乏长期的临床证据。本综述的目的在于就小主动脉瓣外科治疗最新进展进行总结，以探讨小主动脉瓣环的外科治疗策略及新技术的应用前景。

• The diagnosis and treatment of aortic diseases has always been the focus of research in the cardiovascular field. The small aortic annulus brings great challenges to the treatment of aortic diseases and is closely related to the poor prognosis of patients. At present, there is no consensus on the surgical treatment of small aortic annulus at home and abroad. For this special group, the existing treatment methods  including aortic root enlargement, transcatheter aortic valve replacement, stentless biological valve, aortic-free valve and new technology have been developed to improve valve hemodynamics and clinical outcomes. However, there are controversies on the choice of treatment methods  and valves, and there is also a lack of long-term clinical evidence for the application of new technology. The purpose of this review is to summarize the latest progress in surgical treatment of small aortic valve, and to explore the surgical treatment strategy and application prospect of new techniques for small aortic annulus.