Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea.
J Korean Med Sci. 2011 Apr;26(4):577-9. doi: 10.3346/jkms.2011.26.4.577. Epub 2011 Mar 28.
Transcatheter aortic valve implantation is an alternative to open heart surgery in high risk patients with severe aortic stenosis. High mortality and complications related to cardiopulmonary bypass for conventional open heart surgery can be avoided with this new less invasive technique. In case of concomitant severe arterial disease, the transapical approach is recommended rather than transfemoral access. An 80-yr-old man with symptomatic aortic stenosis and who had very high surgical risk factors such as diabetes mellitus, hypertension, a history of stroke, bronchial asthma including poor pulmonary function and hepatocellular carcinoma was treated with a transapical aortic valve replacement. The expected mortality in this patient was 25.4% by Euroscore if we performed the conventional aortic valve surgery. The patient was discharged and was well at the 45 follow-up days. We report the first case of successful transcatheter transapical aortic valve implantation which is available recently in Korea.
经导管主动脉瓣植入术是高危重度主动脉瓣狭窄患者的一种替代开胸手术的方法。这种新的微创技术可以避免传统开胸手术中心肺转流相关的高死亡率和并发症。在伴有严重动脉疾病的情况下,建议采用经心尖途径而不是经股动脉途径。一位 80 岁男性,患有症状性主动脉瓣狭窄,且具有极高的手术风险因素,如糖尿病、高血压、中风史、包括肺功能不佳在内的支气管哮喘和肝细胞癌,接受了经心尖主动脉瓣置换术。如果我们进行传统的主动脉瓣手术,该患者的 Euroscore 预期死亡率为 25.4%。患者出院后在第 45 天随访时情况良好。我们报告了首例最近在韩国成功实施的经导管经心尖主动脉瓣植入术。