经股动脉经导管主动脉瓣置换术治疗单纯主动脉瓣关闭不全

【摘要】 目的 探讨Venus-A支架瓣膜行经股动脉经导管主动脉瓣置换术治疗单纯主动脉瓣关闭不全患者的可行性。方法 回顾性调阅2018年12月至2019年12月在阜外医院接受经股动脉经导管主动脉瓣置换术的15例单纯主动脉瓣关闭不全患者的床资料。其中男性12例， 女性3例，年龄68—83岁，平均年龄(74.65±5.52)岁。患者术前均有左心功能不全症状，且术前心脏超声诊断均为单纯主动脉瓣重度返流。结果 患者行经股动脉经导管主动脉瓣置换术。所有病例成功植入Venus-A支架瓣膜。全组病例无死亡。出院前对患者进行临床评估和超声心动图检查。术中行瓣中瓣治疗3例，少量瓣周返流2例。其余病人均无明显瓣周返流，并且顺利出院。结论 经股动脉经导管主动脉瓣置换术治疗单纯主动脉瓣关闭不全患者是可行的，术后早期结果满意。

ransfemoral transcatheter aortic valve replacement for pure aortic regurgitation

Abstract Purpose: This study aimed to investigate the procedural feasibility of transfemoral transcatheter aortic valve replacement for patients with pure aortic regurgitation using Venus-A valve (Venus Medtech Inc., Hangzhou, China) and the short outcomes of these patients. Methods: The study protocol was approved by the institutional ethics committee of Fuwai hospital, and all enrolled patients signed the informed consent before inclusion. Seven patients with pure aortic regurgitation received transfemoral transcatheter aortic valve replacement with Venus-A valve (off-label and non-dedicated) between December 2018 and March 2019. These patients were diagnosed with pure aortic regurgitation by the examination of ultrasonic cardiogram, and the pure aortic regurgitation indicated that the calcified component was not found in aortic annulus and valve leaflets. All perioperative information was recorded, and these patients have a follow-up after surgery from 1 month to 4 months. Results: Of the seven patients in our study, 6 (85.71%) were male. The mean age of all patients was 74.00±5.00 years, and all enrolled individuals involved with the symptom caused by chronic left heart failure before surgery. Five patients have a satisfying location of the transcatheter heart valve. Positioning was not very satisfied in 1 patient (14.29%), resulting in a mild perivalvular leak. A second THV was implanted successfully at the same sitting in 1 patient (14.29%). There is no death or heart-related serious adverse events in enrolled patients at the perioperative period and follow-up. Conclusion: It is a feasible way that transfemoral transcatheter aortic valve replacement was used to treat the patients with pure aortic regurgitation, and the short outcome is good for these patients.