新型冠状病毒感染后经导管主动脉瓣置换术安全性分析

Safety analysis of 19 cases of transcatheter aortic valve replacement after COVID-19 infection

目的观察症状性主动脉瓣狭窄患者感染新型冠状病毒在抗原转阴后行经导管主动脉瓣置换术(TAVR)治疗的安全性。方法选取2022年12月9日至2023年1月13日在上海7家三甲医院行TAVR手术治疗的感染新型冠状病毒后抗原转阴15 d内的症状性重度主动脉瓣狭窄患者19例,总结患者术前一般情况、疾病史、术前检查、手术过程、术后检查、并发症情况和出院情况进行分析。结果2例患者为普通型新型冠状病毒肺炎,其余为轻型。所有患者均顺利完成手术,其中瓣中瓣植入1例。术后有3例患者因完全性房室传导阻滞行起搏器植入,1例患者出现脑卒中,无轻中度及以上瓣周漏、冠状动脉阻塞及死亡病例。结论症状性主动脉瓣狭窄患者在感染轻型或普通型新型冠状病毒肺炎后抗原转阴15 d内行TAVR手术是安全的。

Objective To observe the safety of transcatheter aortic valve replacement(TAVR)for symptomatic aortic valve stenosis patients infected with Corona Virus Disease 2019(COVID-19)and with negative antigen.Methods Ninteen patients with symptomatic severe aortic valve stenosis were performed TAVR in 7 hospitals in Shanghai from December 9th,2022 to January 13th,2023.The patients were infected with COVID-19 and the antigen turned negative within 15 days.The general conditions,disease history,preoperative examinations,procedures,postoperative examinations,complications and discharge conditions of the patients were summarized and analyzed.Results Two of the patients were ordinary COVID-19 pneumonia,and the rest were mild.All patients successfully completed the operation,including 1 case of valve-in-valve implantation.Three patients had pacemaker implantation due to complete atrioventricular block,and 1 patient had stroke after operation.There was no mild to moderate or above perivalvular leakage,coronary occlusion or death happened.Conclusion It is safe for symptomatic aortic valve stenosis patients to perform TAVR within 15 days after antigen negative conversion after infection with mild or common COVID-19 pneumonia.