既往冠状动脉搭桥术后的主动脉瓣狭窄：经导管瓣膜植入术还是主动脉瓣置换术？
Aortic valve stenosis after previous coronary bypass: transcatheter valve implantation or aortic valve replacement?
作者信息
Jegaden Olivier, Lapeze Joel, Farhart Fadi, de Gevigney Guy
机构信息
Department of Cardiac Surgery and Transplantation, Hospital Louis Pradel, University Claude Bernard Lyon 1, INSERM Carmen, 28 Avenue du doyen LEPINE, Bron 69677, France.
出版信息
J Cardiothorac Surg. 2012 May 29;7:47. doi: 10.1186/1749-8090-7-47.
Abstract
We report a prospective comparison between transcatheter valve implantation (TAVI, n = 13) and surgical aortic valve replacement (AVR, n = 10) in patients with severe aortic valve stenosis and previous coronary bypass surgery (CABG). All patients had at least bilateral patent internal thoracic arteries bypass without indication of repeat revascularization. After a similar post-procedure outcome, despite one early death in TAVI group, the 1-year survival was 100% in surgical group and in transfemoral TAVI group, and 73% in transapical TAVI group. When previous CABG is the lone surgical risk factor, indications for a TAVI procedure have to be cautious, specially if transfemoral approach is not possible.
摘要
我们报告了在严重主动脉瓣狭窄且既往有冠状动脉搭桥手术（CABG）的患者中，经导管瓣膜植入术（TAVI，n = 13）与外科主动脉瓣置换术（AVR，n = 10）之间的前瞻性比较。所有患者至少有双侧胸廓内动脉搭桥且无再次血运重建的指征。尽管TAVI组有1例早期死亡，但术后结果相似，外科手术组和经股动脉TAVI组的1年生存率为100%，经心尖TAVI组为73%。当既往CABG是唯一的手术风险因素时，TAVI手术的指征必须谨慎，特别是在无法采用经股动脉途径时。
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