重庆首例经导管主动脉瓣置换术及文献回顾

Transcatheter aortic valve replacement(TAVR):The first case in Chongqing and review of literature

目的:提高临床医生对经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)的认识。方法:通过对1例TAVR手术患者的诊治过程及术中影像资料的介绍,结合文献阐述该手术的适应证、人工瓣膜、手术并发症及前景。结果:本例患者因心衰入院,超声心动图提示为重度主动脉瓣狭窄,内科保守治疗效果不佳,外科手术风险较高,予以TAVR治疗。术后患者心衰症状消失,超声心动图显示主动脉瓣跨瓣压差明显降低,术后3个月左室内径明显减小。结论:TAVR对患者创伤小,恢复快,已成为严重主动脉瓣狭窄外科手术风险中高危患者的一种选择。

Objective:To improve the understanding of clinicians on transcatheter aortic valve replacement(TAVR). Methods:The diagnosis and treatment course and intraoperative image data of a patient with TAVR surgery were reported. The indications,artificial valves,surgical complications and prospects were discussed through literature review. Results:The patient was hospitalized for heart failure. The echocardiography indicated severe aortic stenosis;conservative treatment was not effective,and the risk of surgical operation was high,so TAVR was choose. After TAVR,the heart failure symptoms disappeared,and echocardiography showed significant decrease in aortic valve differential pressure. The left ventricular diameter decreased significantly 3 months after surgery. Conclusion:TAVR surgery is less traumatic and patients recover quickly. TAVR surgery has become a choice for severe aortic stenosis patients with middle-high risk of surgery.