Quebec Heart & Lung Institute, Quebec city, Quebec, Canada.
Catheter Cardiovasc Interv. 2012 Apr 1;79(5):789-93. doi: 10.1002/ccd.23198. Epub 2011 Dec 8.
We present the case of an 85-year-old woman diagnosed with severe aortic stenosis, porcelain aorta, and a small aortic annulus (17.3 mm), who underwent successful transfemoral transcatheter aortic valve implantation (TAVI) with a 20-mm Edwards SAPIEN XT valve using the NovaFlex+ delivery system. At 1-month follow-up the patient was in NYHA functional class I, and Doppler echocardiography showed a mean residual gradient of 15 mm Hg and trivial paravalvular aortic regurgitation. This case, which shows for the first time the feasibility of TAVI with a 20-mm valve, opens a new avenue for the challenging treatment of patients with aortic stenosis and a small aortic annulus.
我们报告了一例 85 岁女性患者，诊断为严重主动脉瓣狭窄、主动脉瓣瓷化病和小主动脉瓣环（17.3mm），使用 NovaFlex+输送系统成功进行了经股动脉经导管主动脉瓣置换术（TAVI），植入了 20mm 的 Edwards SAPIEN XT 瓣膜。术后 1 个月随访时，患者心功能 NYHA 分级为 I 级，多普勒超声心动图显示平均残余梯度为 15mmHg，轻微瓣周主动脉瓣反流。该病例首次证明了使用 20mm 瓣膜进行 TAVI 的可行性，为治疗主动脉瓣狭窄伴小主动脉瓣环的患者提供了新的途径。
