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目的:探讨Venus-A瓣膜支架经股动脉入路置入治疗单纯主动脉瓣关闭不全的临床疗效。方法:选取2020年9月—2022年2月于河北医科大学第二医院心脏外科行经股动脉经导管主动脉瓣置换术的单纯主动脉瓣关闭不全患者18例,对其围手术期资料进行回顾性分析。结果:18例患者均顺利完成手术,并成功置入Venus-A瓣膜支架25枚(6例实施了“瓣中瓣”手术,其中1例“瓣中瓣”手术共置入3枚Venus-A瓣膜支架),“瓣中瓣”置入率为33%。术后轻度瓣周反流15例,其余患者无瓣周反流;术后新发一过性Ⅲ度房室传导阻滞,后转为完全性左束支传导阻滞1例,其余患者均未出现严重不良事件。术后1周,患者均顺利出院。结论:Venus-A瓣膜支架经股动脉入路置入治疗单纯主动脉瓣关闭不全安全、有效。 相似文献
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经导管主动脉瓣置换术(TAVR)已成为国内外指南推荐治疗老年主动脉瓣狭窄(AS)的一线治疗方案,也适用于AS合并不同严重程度主动脉瓣反流的患者,但在单纯主动脉瓣反流(PAR)中却不做常规推荐,传统外科主动脉瓣置换术仍然是治疗PAR的金标准。外科手术禁忌或高危PAR患者,常放弃外科手术治疗,选择保守治疗,而后者的死亡率更高。经股动脉TAVR(TF-TAVR)为其提供了一种替代治疗方案,尽管仍面临手术技术要求高、缺乏针对PAR的瓣膜系统和术后长期随访数据等挑战,但随着TAVR技术经验积累、新一代瓣膜系统的发展及长期随访数据的反馈,TF-TAVR治疗PAR逐渐被证实是一种安全、可行的外科手术替代治疗方式,本文对TF-TAVR治疗PAR实施要点、临床研究现状以及未来的发展进行综述。 相似文献
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目的 探讨经导管主动脉瓣置换术治疗高龄主动脉瓣狭窄患者的有效性和安全性.方法 回顾性分析2019年1月至2020年12月于中国医学科学院阜外心血管病医院行TAVR手术的主动脉瓣狭窄患者142例.其中年龄≥80岁患者22例为高龄老年组,65≤年龄<80岁患者120例为老年组,比较2组围手术期结果.采用SPSS 20.0软... 相似文献
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2002年,法国医生Alain Cribier成功完成了全球首例经导管主动脉瓣置换术(TAVR)[1],开创了心脏瓣膜病经导管介入治疗的新纪元.二十年来,器械不断改进、创新,技术不断发展,大量随机对照临床试验证实了其治疗不同外科手术风险的严重主动脉瓣狭窄(AS)的有效性和安全性,使该技术在世界范围内得以推广应用,目前有... 相似文献
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近年来,经导管主动脉瓣置换(TAVI)术发展迅猛。对于外科手术风险很高的严重主动脉瓣狭窄患者,TAVI术已成为一种替代治疗。随着器械的不断改进和临床经验的积累,一些新的技术开始应用于TAVI领域,如非传统的支架输送途径、新材料的带瓣膜支架、局部麻醉下的TAVI术、经导管"瓣中瓣"技术等等。本文将TAVI领域近年来出现的一些新技术作一介绍。 相似文献
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Roberto Spina Omar Khalique Susheel Kodali Vinayak N. Bapat 《Catheterization and cardiovascular interventions》2019,93(5):996-1001
Transcatheter aortic valve replacement (TAVR) is not currently approved for pure native valve aortic incompetence, and is typically performed on a compassionate basis in selected patients who are at high risk for conventional surgery. We describe the first use of TAVR to treat iatrogenic severe acute pure aortic incompetence following mitral valve surgery. A 71‐year‐old gentleman developed life‐threatening acute aortic regurgitation (AR) within hours of a very challenging fifth open heart mitral valve replacement. Careful inspection of echocardiographic and computed tomographic imaging identified the cause as a disrupted left coronary cusp at the commissure caused by the surgical mitral annular reconstruction. Medical management with afterload reduction failed with recurrent pulmonary edema, and a sixth open heart surgery was deemed prohibitively high risk. The lack of aortic annular calcium onto which anchors a transcatheter valve was a concern for TAVR. However, we postulated that the struts of the mitral valve bioprosthesis would offer some support to the TAVR valve. We opted for a self‐expanding system because of concerns about potential unfavorable interaction between the balloon onto which balloon‐expandable bioprosthesis is mounted and the struts of the mitral bioprosthesis, and because the Evolut R system has additional anchoring points at the crown which might enhance transcatheter valve stability in the non‐calcified annulus, compared with the Edwards Sapien system. Transfemoral TAVR, performed with a Medtronic Evolut R 34 mm system under general anesthesia and using moderately rapid ventricular pacing, was successful with minimal residual AR. On follow‐up 1 month later the patient was asymptomatic, and the aortic and mitral bioprostheses were functioning normally on echocardiogram. 相似文献
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Prevalence and impact of preoperative moderate/severe tricuspid regurgitation on patients undergoing transcatheter aortic valve replacement 下载免费PDF全文
Marco Barbanti MD Ronald K. Binder MD Danny Dvir MD John Tan MD Melanie Freeman MBBS Christopher R. Thompson MD Anson Cheung MD David A. Wood MD Jonathon Leipsic MD John G. Webb MD 《Catheterization and cardiovascular interventions》2015,85(4):677-684
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Andras P. Durko Ruben L. Osnabrugge A. Pieter Kappetein 《Trends in Cardiovascular Medicine》2018,28(3):174-183
Transcatheter aortic valve replacement (TAVR) revolutionized the treatment of severe symptomatic aortic stenosis (AS). TAVR is increasingly offered for lower-risk patients. The role and place of TAVR in the future treatment of AS is not clear yet. In this review, we discuss the long-term outlook for TAVR, its challenges and its relationship to conventional surgical aortic valve replacement. 相似文献
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Sex differences in postprocedural aortic regurgitation and mid‐term mortality after transcatheter aortic valve implantation 下载免费PDF全文
Giuseppe Ferrante MD PhD Paolo Pagnotta MD Anna Sonia Petronio MD Francesco Bedogni MD Nedy Brambilla MD Claudia Fiorina MD Cristina Giannini MD Marco Mennuni MD Federico De Marco MD Silvio Klugmann MD Federica Ettori MD Patrizia Presbitero MD 《Catheterization and cardiovascular interventions》2014,84(2):264-271
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Claudia A. Martinez MD William W. O'Neill MD 《Catheterization and cardiovascular interventions》2013,82(4):E587-E591
In the era of transcatheter aortic valve therapies, the presence of residual paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR) may become a clinical challenge. Management of late symptomatic PVR is still unknown. We describe a challenging case of percutaneous closure attempt of a clinically significant PVR in a patient after Edwards SAPIEN (Edwards Lifesciences, CA) TAVR. © 2012 Wiley Periodicals, Inc. 相似文献