【摘要】 目的分享经导管主动脉瓣植入术(TAVI)治疗重度主动脉瓣狭窄患者的经验。方法分析已完成TAVI患者的基线特征、术后血流动力学变化情况及临床结果。结果 2012年4月至2014年3月共36例患者于四川大学华西医院进行TAVI,平均年龄(73.9±7.2)岁,其中男24例(66.7%),平均欧洲心脏手术风险回归评分为(20.6±9.9)%。25例(69.4%)患者主动脉瓣叶形态呈二叶式畸形。TAVI成功35例(97.2%),4例(11.1%)需植入第2枚瓣膜。术后主动脉瓣平均跨瓣压差下降至(10.5±5.7)mmHg(1 mmHg=0.133 kPa),2例残余瓣周漏接近中度。术后30 d内死亡1例(2.8%),脑卒中2例(5.6%)。10例(27.8%)患者因出现Ⅲ度房室传导阻滞而植入了永久起搏器。中位随访时间323 d,除2例患者分别于术后374 d和680 d死于恶性肿瘤外,其余患者均保持无症状生存。结论对于不适合进行外科手术的二叶式和三叶式主动脉瓣重度狭窄患者,TAVI是可行、安全和有效的。更多还原

【Abstract】 Objective To discuss the preliminary experience of transcatheter aortic valve implatantion in patients with severe aortic valve stenosis. Methods The baseline characteristics, hemodynamic changes and clinical outcomes of the patients received TAVI in our institution were analyzed. Results A total of 36 patients underwent TAVI between April 2012 and March 2014. The mean age was(73.4±8.7) years and 24(66.7%) of them were men. The mean logistic EuroSCORE was(20.6±9.9)%. 25(70%) patients had bicuspid aortic valves. TAVI was successful in 35 patients(97.2%) and valve-in-valve implantation was required in 4(11.1%) of them. After the procedure, the mean aortic-valve gradient reduced to(10.5±5.7) mmHg. In 2 patients(5.6%), there was marginal moderate periprosthetic leak. At 30 days, the survival rate was 97.2%. Two patients(5.6%) developed who later showed fuel recovery, without signifi cant sequela. Permanent pacemakers were implanted in 10 patients(27.8%) due to the onset of third-degree atrioventricular block after TAVI. To date, the median follow-up duration has exceeded 323 days. 2 patients died of cancer on 374 days and 680 days after TAVI, respectively. Conclusions TAVI is feasible, safe and effective in treating severe stenosis of bicuspid as well as tricuspid aortic valve in selected Chinese patients unsuitable for surgery.更多还原