Ge Jun-bo, Zhou Da-xin, Pan Wen-zhi, Guan Li-hua, Yao Kang
Department of Cardiology, Zhongshan Hospital, Shanghai 200032, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2011 Nov;39(11):989-92.
To evaluate the safety and efficacy and summarize the initial experience of transcatheter aortic valve implantation (TAVI) for treating patients with severe aortic stenosis.
From October 2010 to May 2011, TAVI using 18 F Corevalve system was applied in 3 patients with severe calcified aortic valve stenosis at high risk for surgery. The efficacy and complications of the procedure were analyzed and the procedure experiences were summarized.
TAVI procedure was successful in all 3 cases. The mean operation time was (109.0 ± 22.6) minutes and X-ray exposure time was (24.0 ± 9.5) minutes. The peak pressure gradients after surgery were significantly reduced [from (84 ± 15) mm Hg (1 mm Hg = 0.133 kPa) to (6 ± 3) mm Hg]. A trivial to mild paravalvular leak was observed in all patients post procedure. Case 1 was free from perioperative complications. Case 2 experienced a transient complete left bundle branch block. Case 3 developed 3 degree atrioventricular block and implanted with a permanent cardiac pacemaker, cardiac tamponade which was relieved through conservative treatment, including pericardial puncture and drainage and acute kidney injury.
Our initial experience showed that TAVI using the 18 F Corevalve system is safe and effective for patients with severe calcified aortic valve stenosis at high-risk for surgery, though the procedure may cause some complications. Strict patient selection and proficient surgical techniques may reduce the incidence of complications.
评估经导管主动脉瓣植入术(TAVI)治疗严重主动脉瓣狭窄患者的安全性和有效性,并总结初步经验。
2010年10月至2011年5月,对3例手术高危的严重钙化性主动脉瓣狭窄患者应用18F Corevalve系统进行TAVI。分析该手术的疗效和并发症,并总结手术经验。
3例患者TAVI手术均成功。平均手术时间为(109.0±22.6)分钟,X线暴露时间为(24.0±9.5)分钟。术后峰值压力阶差显著降低[从(84±15)mmHg(1mmHg = 0.133kPa)降至(6±3)mmHg]。术后所有患者均观察到轻微至轻度瓣周漏。病例1无围手术期并发症。病例2出现短暂性完全性左束支传导阻滞。病例3发生三度房室传导阻滞并植入永久性心脏起搏器,出现心脏压塞,通过保守治疗(包括心包穿刺引流)得以缓解,还出现急性肾损伤。
我们的初步经验表明,对于手术高危的严重钙化性主动脉瓣狭窄患者,使用18F Corevalve系统进行TAVI是安全有效的,尽管该手术可能会引起一些并发症。严格的患者选择和熟练的手术技术可能会降低并发症的发生率。