Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy.
Catheter Cardiovasc Interv. 2013 Apr;81(5):864-70. doi: 10.1002/ccd.24479. Epub 2012 Sep 19.
We evaluated transcatheter aortic valve Implantation (TAVI) in high-risk patients with severe aortic regurgitation (AR) in native or degenerated bioprosthetic valves.
TAVI has emerged as a viable treatment modality for severe aortic stenosis in inoperable or high-risk patients. The use of TAVI for treatment of severe AR has remained largely unexplored.
Eight patients (age 79.6 years ± 5.75 years) with severe AR underwent TAVI at six tertiary hospitals between April 2010 and May 2011. All patients were considered to be at prohibitive risk for surgical aortic valve replacement (SAVR).TAVI with the nitinol based Core Valve bioprosthesis (CRS) (Medtronic) was performed in all patients.
Transfemoral access was used in all cases. Procedural success was obtained in all cases without any intraprocedural complications. There was no in hospital or 30-day mortality. There were no cases of atrioventricular blocks requiring permanent pacemaker implantation. At a mean follow up of 15.5 ± 15 months; all patients had improvement in New York Heart Association functional class. Follow up echocardiography revealed improved or stable left ventricular ejection fraction and optimal device function in all cases.
TAVI with the CRS bioprosthesis is feasible and effective in appropriately selected cases of severe aortic regurgitation in native and bioprosthetic aortic valves.
我们评估了经导管主动脉瓣植入术（TAVI）在有严重主动脉瓣反流（AR）的高危患者中的应用，这些患者的主动脉瓣为原生或退行性生物瓣。
TAVI 已成为不能手术或高危患者严重主动脉瓣狭窄的可行治疗方法。TAVI 治疗严重 AR 的应用仍在很大程度上尚未得到探索。
2010 年 4 月至 2011 年 5 月，六家三级医院对 8 例（年龄 79.6 岁±5.75 岁）严重 AR 患者进行了 TAVI。所有患者均被认为不适合外科主动脉瓣置换术（SAVR）。所有患者均采用基于镍钛诺的 Core Valve 生物瓣（CRS）（美敦力）进行 TAVI。
所有病例均采用经股动脉入路。所有病例均获得了手术成功，无术中并发症。无院内或 30 天死亡率。无一例房室传导阻滞需要植入永久性起搏器。平均随访 15.5±15 个月；所有患者纽约心脏协会功能分级均有改善。随访超声心动图显示所有病例左心室射血分数均有改善或稳定，器械功能良好。
在适当选择的原生和生物瓣主动脉瓣严重 AR 病例中，采用 CRS 生物瓣的 TAVI 是可行且有效的。
