球扩式主动脉瓣腔内置换术治疗五例主动脉瓣狭窄经验

Balloon-dilated endovascular replacement of aortic valve for severe aortic stenosis:preliminary experience in five cases

目的探讨球扩式主动脉瓣腔内置换术治疗严重主动脉瓣狭窄患者的可行性。方法选取5例术前评估无法耐受传统开放手术的严重主动脉钙化狭窄患者,行经股动脉球扩式主动脉瓣腔内置换术。结果 5例均经股动脉完成,其中1例经心尖穿刺辅助完成,5例手术全部成功,术后患者主动脉瓣功能显著改善,无并发症,无死亡。结论球扩式主动脉瓣腔内置换术可用于严重主动脉瓣狭窄患者,但在术前准备、评估、术中操作等方面提出了更高的要求。

Objective To discuss the feasibility of balloon-dilated endovascular replacement of aortic valve for the treatment of severe aortic stenosis. Methods Five patients with severe aortic stenosis were selected for this study. Preoperative evaluation of these patients＇ clinical conditions indicated that these five patients were unable to tolerate a traditional open cardiovascular surgery. Via femoral artery access balloon- dilated endovascular replacement of aortic valve was carried out in all the five patients. The results were analyzed. Results The procedure was accomplished via femoral artery access in all the five patients. In one patient the operation was successfully finished with the auxiliary help of trans- cardiac apex puncturing. Technical success was achieved in all the five patients. After the operation the functioning of the aortic valve was greatly improved. Neither complications nor death occurred in all patients. Conclusion Balloon-dilated endovascular replacement of aortic valve can be safely used for the treatment of severe aortic stenosis in Chinese patients, although more strict preoperative preparation, precise evaluation and careful management during operation are demanded.