Liu Xian-Bao, He Yu-Xin, Liu Chun-Hui, Wang Li-Han, Gao Feng, Yu Lei, Dong Ai-Qiang, Kong Min-Jian, Chen Ji-Fang, Xu Yong, Zhou Qi-Jing, Yan Min, Wang Jian-An
Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Cardiovascular Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
World J Emerg Med. 2018;9(1):64-66. doi: 10.5847/wjem.j.1920-8642.2018.01.010.
No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve.
A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk (STS 13.8%) was recommended for transcatheter aortic valve replacement (TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR. Therefore, we used the retrievable and repositionable VenusA-Plus valve for the patient.
Transfemoral TAVR was performed under local anesthesia with sedation, and a 26mm VenusA-Plus valve was successfully implanted. No transvalvular pressure gradient and trace paravalvular leakage were found.
The successful first-in-man implantation indicates the retrievable and repositionable VenusA-Plus valve is feasible in complicated TAVR cases such as bicuspid aortic valve.
中国尚无可回收和重新定位的第二代经导管主动脉瓣。在此,我们报告首例可回收和重新定位的VenusA-Plus瓣膜人体植入情况。
一名76岁有症状的严重主动脉瓣狭窄且手术风险高(胸外科医师协会评分13.8%)的患者被心脏瓣膜团队推荐行经导管主动脉瓣置换术(TAVR)。通过双源计算机断层扫描确定为0型二叶式主动脉瓣伴不对称钙化,这种不利的解剖结构增加了TAVR期间瓣膜位置不当和瓣周漏的可能性。因此,我们为该患者使用了可回收和重新定位的VenusA-Plus瓣膜。
在局部麻醉加镇静下进行经股动脉TAVR,成功植入一枚26mm的VenusA-Plus瓣膜。未发现跨瓣压差,瓣周漏微量。
首例人体成功植入表明,可回收和重新定位的VenusA-Plus瓣膜在诸如二叶式主动脉瓣等复杂TAVR病例中是可行的。