首批球扩式经导管主动脉瓣置换术10例

The First 10 Balloon Dilated Aortic Valve Replacement Patients in China

目的探讨球扩式经导管主动脉瓣置换术治疗严重退行性主动脉瓣狭窄国人患者的可行性,为本技术在国内开展做出探索,积累经验。方法选取我院2011年1月至2014年3月间,门诊入院65周岁以上严重退行性主动脉瓣狭窄的老年患者共10例经术前评估开放手术高危或手术不耐受。其中男9例、女1例,年龄76.4(65~81)岁。全部患者行经股动脉球扩式经导管主动脉瓣置换术。结果10例手术全部成功,其中1例经辅助心尖穿刺完成,术后患者主动脉瓣功能明显改善,无严重并发症,术后住院时间3~5 d。随访3~34个月,全部患者症状改善,1例患者于术后13个月因肺癌死亡。结论球扩式经导管主动脉瓣置换术可用于国人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 about the using of transcatheter aortic valve implantation(TAVI)in severe aortic valve stenosis Chinese patients,then to make more exploration and accumulate enough experience.Methods We selected 10 out-patients with severe aortic valve stenosis and calcified with 9 males and 1 females at age of76.4(65-81) years in our hospital from January 2011 to March 2014.All the patients can't tolerate traditional open surgery through preoperative evaluation.So we chose the Sepian TX system,balloon dilated transcatheter aortic valve,to treat them via transfemoral approach.Results Ten patients accomplished TAVI successfully.One patient was assisted by the left-ventricular puncture.No complication occurred.The function of aortic valve after TAVI improved significantly.The hospital stay time was 3-5 days.The patients were followed up for 3-34 months.One patient died of pulmonary cancer during the following-up.Conclusions Transcatheter balloon dilated aortic valve replacement can be used in Chinese severe aortic valve stenosis patient,but more accurate preoperative preparation,evaluation,and operation are needed.