Recently, it was learned from Yongchuan Hospital Affiliated to The Heavy Medical Center that the team of Associate Professor Li Chao of the Department of Thoracic and Cardiac Surgery of the Hospital applied the VitaFlow Liberty electric recyclable valve delivery system, and under the guidance of the cardiac experts of the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, successfully performed TAVR surgery for a patient with moderate stenosis and severe reflux in a patient with high risk coronary arteries, which opened the door to the "heart" for the patient.
This is the first severe and complex TAVR operation to be performed in Yongchuan. It is understood that the patient is a female, 66 years old, who reported that she was tired and short of breath after repeated activities for 6 months, aggravated for 14 days. It is diagnosed with valvular heart disease, hypertension grade 1, and chronic obstructive pulmonary disease.
▲Accurate measurement in transesophageal cardiac ultrasound
After the team's evaluation, combined with the root morphology and disease and other factors, it was decided to choose the VitaFlow Liberty electric recoverable valve delivery system, 22mm balloon pre-expansion, pre-installed TAV27 valve, body circulation, planned implantation depth of 1-2mm.
At 6 p.m. on December 8, the catheterization chamber was already in the midst of intense and orderly preparations for surgery. In order to ensure the smooth success of the operation, the multidisciplinary diagnosis and treatment team of thoracic and cardiac surgery and anesthesiology, ultrasound, catheterization, CT room, cardiology and intensive care unit conducted preoperative assessment, intraoperative risk prediction and postoperative rehabilitation management plan for the patient. Preoperative visits are conducted by each specialist to carefully assess the patient's condition, patiently advise the elderly patients on preoperative precautions at the bedside, and constantly use warm words to alleviate the patient's preoperative anxiety.
TAVR surgery is difficult, the need for multidisciplinary "cooperation war", preoperative hospital leaders attach great importance to, held clinical, medical technology, functional department kick-off meeting, medical department organization of preoperative multidisciplinary discussions for many times.
▲Preoperative multidisciplinary seminar
Compared with the traditional open chest surgery with large wounds and long operation time, TAVR surgery does not require chest opening, only needs to be punctured in the femoral artery or apex, and the artificial heart valve is implanted into the heart using a special delivery system to replace the heart with a "door", thereby improving cardiac function and improving quality of life.
▲Heart surgery anesthesia team carefully prepared
How to accurately locate and release the prosthetic valve during surgery is the key to the success of the operation and the technical difficulty. Deputy Director Li Chao explained, "The operation does not open the chest, the trauma is small, the recovery is quick, and the minimally invasive technique is adopted, the aortic valve replacement is carried out through the catheter, and the artificial biological valve device is transported to the aortic valve ring through the femoral artery or the apex, and then accurately released under the guidance of X-ray and esophageal ultrasound, providing a new treatment method for patients with severe aortic valve lesions." ”
Which patients are suitable for TAVR surgery?
1. Severe aortic valve calcified stenosis in the elderly (whether combined with insufficiency), or dyspensional regurgitation.
2. Patients with symptoms, such as palpitations, chest pain, syncope. For patients who are not candidates for open-chest surgery, or who are too risky to open their surgery.
3. Artificial biological valve decay after surgery. (Textu/Guo Linling)