Observation of the effect of aortic valve placement via femoral artery in the treatment of severe aortic regurgitation
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摘要: 目的:观察经股动脉途径主动脉瓣置入术治疗严重主动脉瓣反流患者的安全性和有效性。方法:选取2017年9月—2020年2月我院经股动脉导管主动脉瓣置换术的72例患者,入选其中11例典型单纯重度主动脉瓣反流者。观察11例患者术前一般资料以及主动脉CT测量结果以及覆膜支架型号,和术后1年患者心脏彩超结果和手术并发症。结果:11例患者术前、术后1周、1个月、3个月、6个月、1年彩超显示:左室射血分数术后开始逐渐提高,手术6个月后,差异较术前明显提高,差异有统计学意义(P<0.05);左室舒张末内径、左心室收缩末容积术后1周开始缩小,手术6个月后,差异较术前明显缩小,差异有统计学意义(P<0.05);左室舒末容积手术1周后开始明显缩小,差异有统计学意义(P<0.05)。总计有2例患者发生完全性左束支传导阻滞,其中一患者术后1周内发生间断三度房室传导阻滞,1周后复查动态心电图未见三度房室传导阻滞再次发生。总计有3例患者发生瓣周漏,这3例患者随访3个月及1年,瓣周漏面积平均分别为2 mm2、2.5 mm2、3.7 mm2,无进行性增加。余患者均未出现房室传导阻滞、瓣周漏、冠状动脉阻塞、卒中等并发症。结论:经股动脉途径主动脉瓣置入术治疗单纯主动脉瓣反流的安全性、疗效性良好。Abstract: Objective: To observe the safety and effectiveness of transarterial aortic valve replacement in the treatment of patients with severe aortic regurgitation.Methods: A total of 72 patients undergoing aortic valve replacement via femoral artery catheter were selected in our hospital from September 2017 to October 2020. Among them, 11 patients with typical simple severe aortic regurgitation were selected. We observed the preoperative general information of 11 patients, the results of CT measurement of the aorta and the model of the stent graft, and the results of color Doppler ultrasound and surgical complications of the patients 1 year after surgery.Results: Color Doppler ultrasound tips for 11 patients before operation, 1 week, 1 month, 3 months, 6 months, 1 year after operation: The left ventricular ejection fraction(LVEF) began to increase gradually after surgery, and the difference was significantly higher than that before surgery after 6 months of surgery(P<0.05); left ventricular end diastolic inner diameter(LVEDd) and left ventricular end systolic volume(LVESV) at 1 weeks began to shrink. After 6 months, the difference was significantly smaller than before operation(P<0.05); The left ventricular end diastolic volume began to decrease significantly after 1 week of surgery(P<0.05). A total of 2 patients had complete left bundle branch block, in which one patient had intermittent degree Ⅲ atrioventricular block within 1 week after the operation, and no recurrence of degree Ⅲ atrioventricular block was found in the dynamic electrocardiogram reexamination 1 week later. A total of 3 patients had perivalvular leakage. The 3 patients were followed up for 3 months and 1 year. The average perivalvular leakage area was 2 mm, 2.5 mm, and 3.7 mm, respectively, with no progressive increase. No complications were found such as atrioventricular block, perivalvular leakage, coronary artery obstruction or stroke occurred in the remaining patients.Conclusion: Transarterial aortic valve implantation is safe and effective for patients with simple aortic regurgitation.
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Key words:
- transfemoral approach /
- aortic valve placement /
- aortic regurgitation
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