Therapeutic effects of transcatheter aortic valve replacement combined with percutaneous coronary intervention and surgical aortic valve replacement combined with coronary artery bypass grafting on patients with aortic stenosis and coronary heart disease

NIU Hongxing; SHI Jingbao; ZHANG Ruicheng; JI Zhanquan

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Therapeutic effects of transcatheter aortic valve replacement combined with percutaneous coronary intervention and surgical aortic valve replacement combined with coronary artery bypass grafting on patients with aortic stenosis and coronary heart disease

Treatise | 更新时间：2026-01-06

- Therapeutic effects of transcatheter aortic valve replacement combined with percutaneous coronary intervention and surgical aortic valve replacement combined with coronary artery bypass grafting on patients with aortic stenosis and coronary heart disease
- J Clin Electrocardiol Vol. 34, Issue 6, Pages: 428-432(2025)
- 作者机构：
  
  1.455000 河南濮阳，濮阳市安阳地区医院心胸外一科（牛红星，石静宝，吉占全）
  2.450000 河南郑州，河南省胸科医院心外科（张瑞成）
- 作者简介：
- 基金信息：
- DOI：
  CLC： R541.7;R540.4+1
- Received：17 December 2024，
  
  Accepted：21 November 2025，
  
  Published：28 December 2025
- 稿件说明：
移动端阅览
牛红星, 石静宝, 张瑞成, 等. 经导管主动脉瓣置换术联合经皮冠脉介入术、外科主动脉瓣置换术联合冠脉旁路移植术治疗主动脉瓣狭窄合并冠心病的效果[J]. 临床心电学杂志, 2025, 34(6): 428-432.

NIU Hongxing,SHI Jingbao,ZHANG Ruicheng,et al.Therapeutic effects of transcatheter aortic valve replacement combined with percutaneous coronary intervention and surgical aortic valve replacement combined with coronary artery bypass grafting on patients with aortic stenosis and coronary heart disease[J].J Clin Electrocardiol,2025,34(06):428-432.
牛红星, 石静宝, 张瑞成, 等. 经导管主动脉瓣置换术联合经皮冠脉介入术、外科主动脉瓣置换术联合冠脉旁路移植术治疗主动脉瓣狭窄合并冠心病的效果[J]. 临床心电学杂志, 2025, 34(6): 428-432. DOI：

NIU Hongxing,SHI Jingbao,ZHANG Ruicheng,et al.Therapeutic effects of transcatheter aortic valve replacement combined with percutaneous coronary intervention and surgical aortic valve replacement combined with coronary artery bypass grafting on patients with aortic stenosis and coronary heart disease[J].J Clin Electrocardiol,2025,34(06):428-432. DOI：

摘要

目的

分析经导管主动脉瓣置换术（TAVR）+经皮冠脉介入术（PCI）与外科主动脉瓣置换术（SAVR）+冠脉旁路移植术（CABG）对主动脉瓣狭窄合并冠心病患者的治疗效果。

方法

收集我院2020年1月至2024年2月间确诊的91例主动脉瓣狭窄合并冠心病患者的资料，行回顾性研究，按照治疗方案分组，行TAVR+PCI的46例为介入组，行SAVR+CABG的45例为外科组。对比两组康复指标、心功能以及并发症状况。

结果

两组呼吸机辅助时间相比较，无明显差异（

0.05）；与外科组相比，介入组（重症监护室）ICU监护时间与术后住院时间均较短（

0.05）；术前、术后3个月两组心功能对比，均无明显差异（

0.05），但术后3个月，两组心功能均优于术前（

0.05）；介入组瓣周漏发生率高于外科组（

0.05）。

结论

TAVR+PCI、SAVR+CABG治疗主动脉瓣狭窄合并冠心病时，均能有效改善心功能，但前者可在缩短康复进程的同时，并发症也相应增加。

Abstract

Objective To analyze the therapeutic effects of transcatheter aortic valve replacement (TAVR) + percutaneous coronary intervention (PCI) and surgical aortic valve replacement (SAVR) + coronary artery bypass grafting (CABG) on patients with aortic stenosis and coronary heart disease.

Methods

The data of 91 patients with aortic stenosis and coronary heart disease confirmed during the period of January 2020 to February 2024 in our Hospital were collected for a retrospective study. According to the treatment plan

46 patients underwent TAVR+PCI were assigned to the interventional group

and 45 patients undergoing SAVR+CABG were assigned to the surgical group. Rehabilitation indicators

cardiac function

and concurrent symptoms were compared between two groups.

Results

There was no significant difference in the duration of ventilator assistance between the two groups (

0.05). Compared with the surgical group

the intervention group (ICU) had shorter ICU monitoring time and postoperative hospitalization time (

0.05). There was no significant difference in cardiac function between the two groups before and 3 months after operation (

0.05)

but 3 months after operation

the cardiac function of the two groups was better than that before operation (

0.05). The incidence of perivalvular leakage in the interventional group was higher than that in the surgical group (

0.05).

Conclusions

When TAVR+PCI and SAVR+CABG are used to treat aortic stenosis with coronary heart disease

both can effectively improve cardiac function

However

the former can shorten the rehabilitation process while increasing complications.

关键词

Keywords

references

瞿三郎 , 黄维勤 , 尹述洲 , 等 . 单纯主动脉瓣重度狭窄患者瓣膜置换术的麻醉处理 [J ] . 海南医学 , 2005 , 16 ( 12 ): 13 - 14 .

牛毅菲 , 贺宇 , 黄琼 , 等 . 经皮冠状动脉介入治疗联合经导管主动脉瓣置换术治疗冠心病合并主动脉瓣疾病的临床疗效 [J ] . 中国心血管病研究 , 2023 , 21 ( 3 ): 263 - 268 .

卢麒麟 , 卫志轩 , 冯策 , 等 . 主动脉瓣狭窄合并冠心病患者行单纯介入治疗与单纯外科治疗的疗效对比分析 [J ] . 临床心血管病杂志 , 2023 , 39 ( 6 ): 428 - 431 .

李辉 , 张闻多 , 汪芳 , 等 . 经完全导管主动脉瓣置换术治疗重度主动脉瓣狭窄合并冠心病患者的诊治进展 [J ] . 中国循环杂志 , 2023 , 38 ( 9 ): 994 - 998 .

王志华 , 赵泽原 , 胡俊龙 , 等 . 经导管与外科主动脉瓣置换术治疗主动脉瓣狭窄合并冠心病的倾向性评分匹配研究 [J ] . 中国胸心血管外科临床杂志 , 2023 , 32 （ 12 ）： 1708 - 1715 .

王华君 , 张航 , 苏彤 , 等 . 一站式TAVR+PCI治疗主动脉瓣病变合并冠心病患者的近期临床疗效分析 [J ] . 中国胸心血管外科临床杂志 , 2024 , 31 ( 6 ): 848 - 852 .

赵建明 , 李峰 , 张华 , 等 . 主动脉瓣疾病合并冠心病患者行经导管主动脉瓣置换术联合经皮冠状动脉介入治疗效果分析 [J ] . 中华实用诊断与治疗杂志 , 2023 , 37 ( 12 ): 1200 - 1204 .

Tsimikas S , Fazio S , Ferdinand KC , et al . NHLBI working group recommendations to reduce Lipoprotein(a)- mediated risk of cardiovascular disease and aortic stenosis [J ] . J Am Coll Cardiol , 2018 , 71 ( 2 ): 177 - 192 .

Steeds RP , Wheeler R , Bhattacharyya S , et al . Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography [J ] . Echo Res Pract , 2019 , 6 ( 2 ): G17 - G33 .

张维明 , 顾立君 , 张晗 , 等 . 基于Revolution CT的冠状动脉血管成像联合血流储备分数评估冠心病并发心力衰竭患者NYHA心功能分级及预后的效果 [J ] . 岭南心血管病杂志 , 2023 , 29 ( 4 ): 395 - 399 .

宋聪慧 , 程帅 , 张申伟 . 超声引导下Venus A-Plus可回收瓣膜输送系统联合TAVR治疗二叶式主动脉瓣狭窄的疗效观察 [J ] . 中西医结合心脑血管病杂志 , 2023 , 21 ( 20 ): 3814 - 3817 .

贺宇 , 牛毅菲 , 黄琼 , 等 . 二尖瓣反流面积分级对重度主动脉瓣狭窄合并二尖瓣关闭不全患者经导管主动脉瓣置换术后预后的影响 [J ] . 实用心脑肺血管病杂志 , 2023 , 31 ( 1 ): 33 - 37 .

Galper BZ , Chinnakondepalli KM , Wang K , et al . Economic outcomes of transcatheter versus surgical aortic valve replacement in patients with severe aortic stenosis and low surgical risk: Results from the PARTNER 3 Trial [J ] . Circulation , 2023 , 47 ( 21 ): 1594 - 1605 .

Gallo M , Fovino LN , Blitzer D , et al . Transcatheter aortic valve replacement for structural degeneration of previously implanted transcatheter valves (TAVR-in-TAVR): a systematic review [J ] . Eur J Cardiothorac Surg , 2022 , 61 ( 5 ): 967 - 976 .

Roth N , Heidel C , Xu C , et al . The impact of bicuspid aortic valve morphology on von Willebrand factor function in patients with severe aortic stenosis and its change after TAVI [J ] . Clin Res Cardiol , 2022 , 111 ( 12 ): 1348 - 1357 .

Sá MP , Sun T , Fatehi Hassanabad A , et al . Complete transcatheter versus complete surgical treatment in patients with aortic valve stenosis and concomitant coronary artery disease: Study-level meta-analysis with reconstructed time-to-event data [J ] . J Card Surg , 2022 , 37 ( 7 ): 2072 - 2083 .

Zasada W , Mikolajczyk F , Jedrychowska M , et al . Comparison of FFR, iFR, and QFR assessment in patients with severe aortic stenosis and coronary heart disease [J ] . Postepy w Kardiologit Interwencyjnej , 2022 , 18 ( 2 ): 118 - 121 .

Calabrò P , Gragnano F . Bleeding in patients undergoing PCI and TAVR: Combining coronary and valve procedures raises new challenges [J ] . JACC Cardiovasc Interv , 2023 , 16 ( 17 ): 2165 - 2168 .

王磊 , 贺吟歌 . 经导管主动脉瓣置换术对中高危老年重度主动脉瓣狭窄患者心肌损伤及心室功能的影响 [J ] . 中华老年心脑血管病杂志 , 2024 , 26 ( 12 ): 1419 - 1423 .

王银凤 , 王忠民 . 经导管主动脉瓣置换术与外科主动脉瓣置换术治疗高危重度主动脉瓣反流的临床疗效对比 [J ] . 中西医结合心脑血管病杂志 , 2024 , 22 ( 10 ): 1861 - 1864 .

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