Chen Shmuel, Zeniou Vicky, Gilon Dan, Planer David, Beeri Ronen, Lotan Chaim, Danenberg Haim D
Cardiology Department, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Harefuah. 2018 Mar;157(3):167-169.
Aortic stenosis is the most common significant valvular disease in the western world. These patients are treated operatively unless they are at high operative risk or inoperable. During the last decade an alternative approach has evolved - transcatheter aortic valve implantation (TAVI). This method was shown to be at least as effective and safe as the operative one. However, very little data exists on long term follow-up (5 years and above), especially regarding valve durability and patient survival.
To present a long term follow-up on patients who underwent transcutaneous self-expandable aortic valve implantation in our department between the years 2008-2011.
In September 2008 the first CoreValve implantation was performed in Israel at Hadassah Medical Center. All records of patients who were transplanted between 9.2008 and 10.2011 were reviewed. The function of the valve early after the procedure was compared to its function at the end of the follow-up period.
A total of 38 patients (out of 71) survived at least 54 months, of them, 19 have an echocardiography examination at the end of the follow-up period. In all patients the implanted valve was found to function well at the end of the follow-up period, without significant stenosis or paravalvular leak. In fact, in approximately half of these patients, the degree of paravalvular leak decreased during the follow-up period.
On long term (5 years) follow-up of patients who were implanted with the self-expandable aortic valve (CoreValve), no deterioration of the valve was observed. In fact, in approximately half of the patients, a decrease in the severity of the paravalvular leak was demonstrated.
在西方世界，主动脉瓣狭窄是最常见的严重瓣膜疾病。除非手术风险高或无法手术，这些患者通常接受手术治疗。在过去十年中，一种替代方法逐渐发展起来——经导管主动脉瓣植入术（TAVI）。事实证明，这种方法至少与手术方法一样有效和安全。然而，关于长期随访（5年及以上）的数据非常少，尤其是关于瓣膜耐久性和患者生存率的数据。
对2008年至2011年间在我院接受经皮自膨胀主动脉瓣植入术的患者进行长期随访。
2008年9月，以色列哈达萨医疗中心首次进行了CoreValve植入术。回顾了2008年9月至2011年10月间所有移植患者的记录。将术后早期瓣膜功能与其在随访期末的功能进行比较。
71例患者中共有38例存活至少54个月，其中19例在随访期末接受了超声心动图检查。在所有患者中，随访期末发现植入的瓣膜功能良好，无明显狭窄或瓣周漏。事实上，在这些患者中约有一半，瓣周漏程度在随访期间有所降低。
对植入自膨胀主动脉瓣（CoreValve）的患者进行长期（5年）随访，未观察到瓣膜恶化。事实上，约一半患者的瓣周漏严重程度有所降低。
