Zahn Ralf, Schiele Rudolf, Kilkowski Caroline, Klein Bärbel, Zeymer Uwe, Werling Christiane, Lehmann Andreas, Gerckens Ulrich, Saggau Werner
Kardiologie/Pneumologie/Angiologie/Internistische Intensivmedizin, Herzzentrum Ludwigshafen, Bremserstrasse 79, D-67063 Ludwigshafen, Germany.
J Heart Valve Dis. 2011 Jan;20(1):64-9.
Transcatheter aortic valve implantation (TAVI) has been introduced for the treatment of severe symptomatic aortic stenosis in patients not suitable for surgical valve replacement. However, a potential problem of TAVI is the development of severe aortic insufficiency after valve implantation due to a too-low implantation of the valve.
Since August 2008, a total of 33 TAVI procedures using the 18 Fr Medtronic CoreValve ReValving system has been performed at the authors' institution.
Severe post-implantation aortic regurgitation occurred in three patients (9%), due to a too-low implantation. Two of these patients underwent a catheter-based repositioning of the valve using a standard snare; the third patient declined any further intervention. Both repositioning procedures were uneventful, with no significant residual regurgitation.
Severe aortic regurgitation after TAVI with the Medtronic CoreValve system is not uncommon. If the valve is implanted too low, a catheter-based valve repositioning may be the method of choice to resolve the problem.
经导管主动脉瓣植入术（TAVI）已被用于治疗不适合外科瓣膜置换的严重症状性主动脉瓣狭窄患者。然而，TAVI的一个潜在问题是瓣膜植入过低导致瓣膜植入后发生严重主动脉瓣关闭不全。
自2008年8月以来，作者所在机构共使用18 Fr美敦力CoreValve再植入系统进行了33例TAVI手术。
3例患者（9%）因植入过低出现严重的植入后主动脉瓣反流。其中2例患者使用标准圈套器对瓣膜进行了基于导管的重新定位；第3例患者拒绝进一步干预。两次重新定位手术均顺利，无明显残余反流。
使用美敦力CoreValve系统进行TAVI后发生严重主动脉瓣反流并不罕见。如果瓣膜植入过低，基于导管的瓣膜重新定位可能是解决该问题的首选方法。
