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

牛红星; 石静宝; 张瑞成; 吉占全

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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

论著 | 更新时间：2026-01-06

- 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
- 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
- 临床心电学杂志 2025年34卷第6期页码：428-432
- 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：
  
  牛红星，主要从事冠心病、结构性心脏病的外科治疗和介入治疗相关研究。E-mail： nnhx02ing@163.com
- 基金信息：
- DOI：
  中图分类号： R541.7;R540.4+1
- 收稿：2024-12-17，
  
  录用：2025-11-21，
  
  纸质出版：2025-12-28
- 稿件说明：
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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

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