MonashHeart, Monash Health, Melbourne, Australia; Monash Cardiovascular Research Centre, Department of Medicine, Monash University, Melbourne, Australia.
Catheter Cardiovasc Interv. 2014 Feb 15;83(3):493-6. doi: 10.1002/ccd.25050. Epub 2013 Jul 24.
Transcatheter aortic valve replacement (TAVR) has become an accepted alternate treatment modality to surgical aortic valve replacement in high surgical risk patients. There remains, however, a subset of patients in whom safe delivery of a TAVR device cannot be achieved by the femoral or subclavian routes. In such cases the direct aortic or transapical routes can be used though this still requires suitable anatomy. We present the first reported case of a direct aortic TAVR using a sheathless technique in order to provide sufficient distance to safely deliver the prosthesis.
经导管主动脉瓣置换术（TAVR）已成为高危外科手术风险患者外科主动脉瓣置换术的一种可接受的替代治疗方法。然而，仍有一部分患者无法通过股动脉或锁骨下动脉安全地输送 TAVR 装置。在这种情况下，可以使用直接主动脉或经心尖途径，但这仍然需要合适的解剖结构。我们报告了首例使用无鞘技术进行直接主动脉 TAVR 的病例，以便提供足够的距离来安全输送假体。
