Booth K, Beattie R, McBride M, Manoharan G, Spence M, Jones J M
Department of Cardiothoracic Surgery, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA.
Department of Cardiology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA.
Ulster Med J. 2016 Jan;85(1):18-22.
Deciding on the optimal treatment strategy for high risk aortic valve replacement is challenging. Transcatheter Aortic Valve implantation (TAVI) has been available in our centre as an alternative treatment modality for patients since 2008. We present our early experience of TAVI and SAVR (surgical Aortic Valve Replacement) in high risk patients who required SAVR because TAVI could not be performed.
The database for Surgical aortic valve and Transcatheter aortic valve replacement referrals was interrogated to identify relevant patients.
Survival to hospital discharge was 95.5% in the forty five patients who had SAVR when TAVI was deemed technically unsuitable. One year survival was 86%.
Defining who is appropriate for TAVI or high risk SAVR is challenging and multidisciplinary team discussion has never been more prudent in this field of evolving technology with ever decreasing risks of surgery. The introduction of TAVI at our institution has seen a rise in our surgical caseload by approximately by 25%. Overall, the option of aortic valve intervention is being offered to more patients in general which is a substantial benefit in the treatment of aortic valve disease.
确定高危主动脉瓣置换的最佳治疗策略具有挑战性。自2008年以来，经导管主动脉瓣植入术（TAVI）在我们中心已作为一种替代治疗方式应用于患者。我们介绍了在因无法进行TAVI而需要外科主动脉瓣置换术（SAVR）的高危患者中TAVI和SAVR的早期经验。
查阅外科主动脉瓣和经导管主动脉瓣置换转诊数据库以确定相关患者。
在TAVI被认为技术上不适用时接受SAVR的45例患者中，出院生存率为95.5%。一年生存率为86%。
确定谁适合TAVI或高危SAVR具有挑战性，在这个技术不断发展、手术风险不断降低的领域，多学科团队讨论从未像现在这样谨慎。我们机构引入TAVI后，外科手术量增加了约25%。总体而言，主动脉瓣干预选项正提供给更多患者，这在主动脉瓣疾病治疗中是一项重大益处。
