Yu Jiwei, Du Run, Ding Fenghua, Zhang Ruiyan, Zhu Zhengbin
Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Cardiovascular Research Institution, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2024 May 9;11:1383264. doi: 10.3389/fcvm.2024.1383264. eCollection 2024.
In high-risk patients with pure native aortic regurgitation (PNAR), transcatheter aortic valve replacement (TAVR) remains an off-label intervention. Due to anatomical variations in the aortic root and technical challenges unique to PNAR, the transfemoral approach (TF-TAVR) requires continued accumulation of experience and technological refinement. In this context, we successfully and safely performed a snare-assisted TF-TAVR procedure for a patient with PNAR, characterized by significant aortic angulation. We introduced an innovative technique termed "snare-assisted coaxiality optimized technique" (SACOT) during valve deployment. SACOT played a crucial role in optimizing valve positioning, enhancing coaxiality, and achieving the ideal implantation depth for PNAR. Post-procedure assessments demonstrated stability and the absence of paravalvular regurgitation (PVR).
在患有单纯原发性主动脉瓣反流（PNAR）的高危患者中，经导管主动脉瓣置换术（TAVR）仍然是一种未获批准的干预措施。由于主动脉根部的解剖变异以及PNAR特有的技术挑战，经股动脉途径（TF-TAVR）需要不断积累经验并改进技术。在此背景下，我们成功且安全地为一名患有PNAR且伴有明显主动脉成角的患者实施了圈套器辅助的TF-TAVR手术。我们在瓣膜植入过程中引入了一种名为“圈套器辅助同轴度优化技术”（SACOT）的创新技术。SACOT在优化瓣膜定位、增强同轴度以及实现PNAR的理想植入深度方面发挥了关键作用。术后评估显示瓣膜稳定且无瓣周反流（PVR）。
