自膨式瓣膜行导管主动脉瓣膜置换术治疗单纯主动脉瓣反流患者35例OACSTPCD

Objective To evaluate the safety and feasibility of transcatheter aortic valve replacement(transcatheter aortic valve replacement,TAVR)in patients with aortic valve regurgitation(aortic regurgitation,AR).Methods Retrospec-tive analysis of 35 patients with severe AR in the Second Hospital of Hebei Medical University from August 2019 to August 2022,including 25 male and 10 female,aged 59 to 83(70.03±1.07).Surgical success rate,mortality rate,incidence of surgical complications and left heart function changes of postoperative patients were analyzed.Results All 35 patients underwent successful transfemoral TAVR procedures with the self-expanding interventional valve,with a 100%success rate and no deaths.17 patients(48.6%)completed the procedure with cardiopulmonary bypass assistance,with the mean time of cardiop-ulmonary bypass assistance(32.5±14.6)min.5 patients(14.3%)were treated with concurrent percutaneous coronary inter-vention(percutaneous coronary intervention,PCI).Fourteen(40.0%)patients used the mediumvalve technique.Preopera-tive LVEF(48.01±12.20)%,1 week LVEF(50.22±15.11)%(t=0.552,P>0.05),preoperative left ventricular end diastolic di-ameter(65.04±10.10)mm,and ventricular end diastolic diameter(63.44±11.03)mm(t=0.710,P>0.05).Before surgery,5 pa-tients had medium or above mitral regurgitation,and postoperative mitral regurgitation was reduced compared with preopera-tive patients.Among them,2 patients turned to small and medium regurgitation,and 3 patients turned to small regurgitation.Immediately aftersurgery,14 cases(40.0%)and 1 third degree block(2.9%)were transferred to cardiology with permanent pacemaker.One intraoperative pericardial effusion(2.9%)was recovered after implantation of the pericardial drainage tube in the median sternal subxiphoid incision.Lowand moderate paravalvular leakage was 3(8.6%);the remaining minor and trace regurgitation was 32(91.4%).Conclusion TAVRwith self-expansive valve via femoral artery is safe for patients with se-vere aortic regurgitation.It has the advantages of less trauma,fewer complications and faster recovery,and is worthy of clinical application.