摘要
目的了解心尖入路J-Valve瓣膜置入术在高危主动脉瓣、二尖瓣疾病中的应用效果。方法回顾性分析2018年6月至2021年1月该院心脏大血管外科收治的采用心尖入路J-Valve瓣膜置入术治疗的高危主动脉瓣、二尖瓣病变患者7例。观察围术期手术效果,随访1~30个月,了解随访期间患者瓣膜功能及心功能改善情况。结果7例患者中行心尖入路经导管主动脉瓣置入术6例,经导管二尖瓣置入术1例;术前平均美国胸外科医师协会评分(6.5±1.3)分,平均欧洲心脏手术风险评估系统Ⅱ评分(4.9±1.5)分;心尖入路经导管主动脉瓣置入术中球囊扩张时出现心室颤动1例,紧急股股转流体外循环辅助下释放成功;心尖部荷包出血1例,术中难止血,术后心功能衰竭死亡;其余患者手术过程均顺利,术后无二度以上房室传导阻滞,随访期间无死亡,无明显瓣周漏,患者心功能状态明显好转。结论心尖入路J-Valve瓣膜置入术是治疗高危心脏瓣膜病的一种较好的选择,瓣膜置入术后近中期随访结果良好。
Objective To understand the application effect of transapical approach J-Valve implantation in high-risk aortic valve and mitral valve diseases.Methods A total of 7 patients with high-risk aortic valve and mitral valve diseases treated by transapical approach J-Valve valve implantation in the cardiovascular surgery department of this hospital from June 2018 to October 2020 were retrospectively analyzed.The perioperative effect was observed.The follow-up lasted for 1-30 months.The valve function and the improvement of heart function were understood during the follow up period.Results Among 7 cases,6 cases underwent transapical approach aortic valve implantation and 1 case underwent transcatheter mitral valve implantation.The preoperative mean STS score was(6.5±1.3)points and the mean EuroscoreⅡscore was(4.9±1.5)points.The ventricular fibrillation occurred in 1 case during balloon dilation in transapical approach aortic valve implantation,the release was successful with the aid of extracorporeal circulation of emergent femoral-femoral bypass.The apical purse-string suture hemorrhage occurred in 1 case,which was difficult to hemostasis and died due to heart failure after operation.The operation process in other cases was smooth.No more than second degree atrioventricular block occurred.There was no death case during the follow-up period.There was no obvious paravalvular leak,and the cardiac function of the patients was significantly improved.Conclusion Transapical approach J-Valve valve implantation is a good choice for the treatment of high-risk heart valvular disease,and the results of early and mid-term follow-up after valve implantation are excellent.
作者
许金国
张成鑫
龚文辉
金朝龙
盛哲
刘海渊
葛圣林
XU Jinguo;ZHANG Chengxing;GONG Wenhui;JIN Chaolong;SHENG Zhe;LIU Haiyuan;GE Shenglin(Department of Cardiovascular Surgery,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China;Cardiac Color Echocardiography Room,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)
出处
《重庆医学》
CAS
2022年第13期2161-2165,共5页
Chongqing medicine
基金
安徽省教育厅高校自然科学研究项目(KJ2019A0246)。
