经心尖植入二代J-ValveTM治疗以关闭不全为主的主动脉瓣病变的初步结果

Transapicaltranscatheter aortic valve replacement for predominant aortic regurgitation of the second generation J-ValveTM and early outcome

目的总结采用最新设计的经心尖主动脉瓣植入系统J-Valve^TM治疗以关闭不全为主的高危主动脉瓣疾病患者的初步临床经验。方法 4例以主动脉瓣关闭不全为主的高危主动脉瓣病变的患者于2018年6月至2019年1月在我科接受经心尖主动脉瓣植入术,纳入的所有患者术前均经心脏团队评估。详细记录及分析手术过程及初步临床结果。结果所有患者均成功经心尖植入新一代J-Valve^TM主动脉瓣。术中2例出现轻微瓣周漏,出院前经超声心动图确认瓣周漏消失。1例术前为高度房室传导阻滞患者,术后二周植入永久心脏起搏器。余患者围手术期未出现并发症。随访31~190 d,平均(111.0±76.87)d。4例患者心功能均为NYHAⅡ级以下。结论本研究初步临床结果表明采用新一代的J-Valve^TM植入系统能够较好解决以关闭不全为主的主动脉瓣疾病,尤其适合术前评估为高危患者。

Objective To summarize the initial clinic experience with the newly designed transapical aortic valve implantation system J-ValveTM for the treatment of high-risk aortic valve disease patients with severe aortic valve regurgitation. Methods Four high-risk aortic valve disease patients with severe aortic regurgitation treated with transapical aortic valve replacement from June 2018 to January 2019 were collected. All patients were evaluated by the cardiac team before surgery. The surgical procedure and preliminary clinical results were recorded and analysed. Results All patients were successfully implanted a new generation of J-Valve^TM aortic valve through the apex of heart. During the operation,two cases had mild paravalvular leakage,and the peravalvular leakage disappeared before discharge. One patient had a high degree of atrioventricular block before the surgery,then a permanent cardiac pacemaker was placed two weeks later. All patients were followed up for 31 ~ 190 days with an average of(111.0 ± 76.87)days. The patient′s heart function was increased over NYHA class II. Conclusions The preliminary results of this study demonstrate that transapical implantation of the new generation of JValve^TM implant system in aortic valve diseases patients with predominant aortic regurgitation,especially for high-risk patients in the preoperative assessment was feasible.