经导管主动脉瓣植入术4例

Four cases of transcatheter aortic valve implatation

本文报道了2018至2020年云南省第一人民医院为4例主动脉瓣病变患者行经导管主动脉瓣植入术(transcatheter aortic valve implantation,TAVI),其中3例为主动脉瓣重度狭窄患者,1例为主动脉瓣重度关闭不全患者,重度关闭不全患者采用瓣中瓣方法进行治疗。4例患者手术顺利,术后恢复可,术后10小时开始下床活动。术后5天复查各项指标满意,均已出院。随访至2020年10月,所有患者未见不适。通过4例患者可见,TAVI对外科手术风险评估为中危以上的主动脉瓣狭窄或符合条件的关闭不全的老年患者效果良好,而经股动脉入路是首选的入路方式。

From 2018 to 2020,four patients with aortic valve disease in the First People's Hospital of Yunnan Province underwent transcatheter aortic valve implantation(TAVI).Three of the patients had severe aortic stenosis,and one patient had severe aortic regurgitation.The valve-in-valve method was used for the patient with severe aortic regurgitation.The operations for all 4 patients went smoothly and they were able to mobilize out of bed 10 hours after surgery.Five days postoperatively,all relevant indicators were satisfactory and they were able to be discharged.All patients had no discomfort on follow-up up to October 2020.It can be seen from these four patients that TAVI surgery is highly recommended for patients with aortic stenosis or other eligible dysfunctions which are assessed to be a risk for older patients,and the transfemoral approach is preferred.