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    find Keyword "aortic valve" 190 results
    • Advantages and related developments of self-expandable valves for transcatheter aortic valve replacement

      Transcatheter aortic valve replacement is an effective treatment for aortic stenosis currently, especially in elderly, surgical high-risk, and surgical procedures-intolerant patients with severe aortic stenosis. After several generations of updates in design and function, the self-expandable valves have shown significant efficacy in treating aortic stenosis patients with bicuspid aortic valve, bioprosthetic valve failure or small annulus, and superiority in terms of valve durability, and the favorable hemodynamic outcomes could translate into clinical endpoint benefit. This literature review summarizes the advantages and recent advances of the self-expandable valves in transcatheter aortic valve replacement.

      Release date:2023-12-25 11:45 Export PDF Favorites Scan
    • Progress in the care of complications after transcatheter aortic valve replacement

      In recent years, heart valve disease has been increasing year by year. Transcatheter aortic valve replacement (TAVR) has become the first-line surgical method for patients with severe aortic stenosis due to the advantages of small surgical trauma and rapid postoperative recovery. In the context of the rapid development of TAVR, the postoperative complications of TAVR seriously affect the surgical success rate and patient prognosis. Therefore, the prevention and nursing of complications after TAVR are particularly important. This article will review the assessment, prevention and care of the complications such as arrhythmia, vascular complications, perivalvular leakage, stroke, and acute renal failure after TAVR in combination with the current situation at home and abroad, in order to enhance the clinical medical workers’ understanding of the complications.

      Release date:2023-06-21 09:43 Export PDF Favorites Scan
    • Investigation and analysis of operations, intraoperative instruments and nursing status of transcatheter aortic valve replacement in China

      ObjectiveTo investigate the operation of transcatheter aortic valve replacement (TAVR), the use of TAVR instruments and the current situation of TAVR-related nursing in our country, to reveal the characteristics of TAVR in various hospitals in our country, and to provide reference data for improving perioperative nursing and industry development of TAVR. MethodsA questionnaire survey was conducted among the head nurses of the cardiac catheterization laboratories of 51 hospitals in China that carried out TAVR operations, with a total of 5 items and 23 questions. The current situation of TAVR operation methods, intraoperative instruments and nursing care in China were analyzed. ResultsThe number of hospitals in China which started conducting TAVR and the beginning year were: 2 in 2010, 1 in 2012, 1 in 2013, 1 in 2015, 11 in 2016, 13 in 2017, 15 in 2018 and 7 in 2019; the number of transfemoral TAVR in 2019: 32 (62.75%) hospitals conducted on less than 20 patients, 7 (13.73%) hospitals 20-<50 patients, 6 (11.76%) hospitals 50-100 patients and 6 (11.76%) hospitals more than 100 patients; TAVR strategies adopted by most hospitals were: general anesthesia (90.20%), the use of vascular sealers (80.39%), backing by cardiac surgeon (74.51%) and using homemade prosthetic valves. Conclusion At present, the number of TAVR carried out in Chinese hospitals is still far behind that of developed countries in Europe and the United States. Our country has adopted the form of multidisciplinary cardiac team cooperation and formed a TAVR nursing model with Chinese characteristics.

      Release date:2022-02-15 02:09 Export PDF Favorites Scan
    • A case report of transcatheter aortic valve replacement with descending aorta severe distortion

      An 89 years old male patient was admitted to the First Medical Center of Chinese PLA General Hospital due to chest tightness and shortness of breath for half a month. Severe aortic valve stenosis was found in post admission assessment. We proposed to perform transcatheter aortic valve replacement surgery. Preoperative evaluation showed severe distortion of the descending aorta. We used the double guide wire technique and a 14F long sheath to assist the stepwise balloon expansion, and successfully completed the valve implantation. For patients with severe tortuous aorta, how to successfully complete transcatheter aortic valve replacement, this case may provide some reference.

      Release date:2020-05-26 02:34 Export PDF Favorites Scan
    • Preliminary analysis of subclinical leaflet thrombosis after percutaneous aortic valve replacement with balloon dilation

      ObjectiveTo analyze the factors influencing the occurrence of subclinical leaflet thrombosis (SLT) after percutaneous aortic valve replacement using balloon-expandable valve (Sapien3, S3). Methods Retrospective analysis was made on 62 patients with severe aortic stenosis undergoing percutaneous aortic valve replacement using S3 in our center from September 2020 to June 2022. Patients with a history of vascular atherosclerosis or with significant increase or insignificant decrease of aortic valve flow or gradient pressure during follow-up were selected for CT examination. Results A total of 26 patients were finally included, with an average age of 70.31±8.90 years, and the male proportion was higher (n=15, 57.69%). Among them, 5 patients had SLT. Compared with the non-SLT group, patients in the SLT group were older (68.52±8.80 years vs. 77.80±4.66 years, P=0.007). The age factor (≥75 years) and the diameter of the ascending aorta were associated with SLT (both P<0.05). Conclusion The incidence of SLT is higher in the elderly patients. It is speculated that SLT is related to the characteristics of short balloon dilation valves and low blood flow dynamics of valve racks.

      Release date:2023-03-01 04:15 Export PDF Favorites Scan
    • Research progress of transcatheter aortic valve replacement related coronary obstruction

      Coronary artery obstruction is a rare but fatal complication of transcatheter aortic valve replacement. Although there is no accepted criteria to fully evaluate the occurrence of coronary artery obstruction, studies have revealed many important risk factors, and some preventive measures have also been found to reduce their occurrence. At present, transcatheter aortic valve replacement is in a stage of rapid development in China, but clinical medical workers’ knowledge of coronary artery obstruction as a complication still needs to be improved. This article discusses the incidence, risk factors, predictive assessment, prevention, treatment and prognosis of coronary artery obstruction complicated by transcatheter aortic valve replacement, so as to increase clinical medical workers’ understanding of this complication.

      Release date:2020-10-26 03:00 Export PDF Favorites Scan
    • Clinical research status and progress of redo-transcatheter aortic valve replacement for structural biovalvular degeneration

      Biological valves can lead to structural valve degeneration (SVD) over time and due to various factors, reducing their durability. SVD patients need to undergo valve replacement surgery again, while traditional open chest surgery can cause significant trauma and patients often give up treatment due to intolerance. Research has shown that as an alternative treatment option for reoperation of thoracic valve replacement surgery, redo-transcatheter aortic valve replacement for SVD is safe and effective, but still faces many challenges, including prosthesis-patient mismatch, high cross valve pressure difference, and coronary obstruction. This article aims to review the strategies, clinical research status and progress of redo-transcatheter aortic valve replacement in SVD patients.

      Release date:2024-02-29 12:02 Export PDF Favorites Scan
    • One-stop operation of percutaneous coronary intervention for left main bifurcation disease and transcatheter aortic valve replacement: a case report

      Transcatheter aortic valve replacement (TAVR) has become one of the main treatments for severe aortic stenosis. However, percutaneous coronary intervention (PCI) is often required in elderly patients who combine with coronary artery disease. This paper reports a case of one-stop TAVR+PCI operation for a 71-year-old male patient with left main bifurcation lesions and severe aortic stenosis. During the procedure, first of all, the coronary arteries were assessed by angiography, and the pigtail catheter was implanted in the left ventricle after the straight guidewire transvalved successfully; then PCI was performed on the diseased coronary arteries; finally, the stenosis of aortic valve was treated with TAVR. After operation, the hemodynamics of the patient was stable and symptoms were significantly improved, showing a good clinical effect of one-stop operation of TAVR+PCI.

      Release date:2022-05-24 03:47 Export PDF Favorites Scan
    • Research progress of coronary artery occlusion associated with transcatheter aortic valve implantation

      Transcatheter aortic valve implantation (TAVI) has become the main treatment for elderly patients with middle and high risk aortic stenosis. However, coronary artery occlusion (CAO) related to TAVI is a very serious complication, which often leads to poor prognosis. Therefore, active preoperative prevention is particularly important. Preoperative computed tomography evaluation, bioprosthetic or native aortic scallop intentional laceration and chimney stent implantation technology can prevent TAVI-related coronary orifice obstruction. Ensuring commissural alignment during operation can reduce the occurrence of coronary occlusion, but its long-term prognosis needs further study. In addition, percutaneous coronary intervention is the main treatment, but there are problems such as difficult coronary access after TAVI. This article summarized the research progress in the mechanism, prevention and treatment of CAO related to TAVI.

      Release date:2023-07-25 03:57 Export PDF Favorites Scan
    • Enhanced recovery after surgery protocol in patients undergoing transapical transcatheter aortic valve implantation

      Objective To report our experience with enhanced recovery after surgery (ERAS) protocol in patients undergoing transapical transcatheter aortic valve implantation (TAVI) and to determine perioperative predictors for ERAS failure. Methods Between May 2018 and January 2019, 80 patients undergoing TAVI in our hospital were recruited. Among them, 40 patients (24 males, 16 females, aged 73.0±5.0 years) successfully received ERAS, defined as successful extubation in operating room (an ERAS group) and the other 40 patients (28 males, 12 females, aged 73.0±7.0 years, a non-ERAS group) failed to perform ERAS. Results Compared with the non-ERAS group, patients in the ERAS group were associated with a significantly lower incidence of postoperative complications (30.0% vs. 52.5%, P=0.04), shorter postoperative ICU stay (2.2±0.4 d vs. 4.0±4.8 d, P=0.00) and hospital stay (7.0±2.3 d vs. 9.5±4.8 d, P=0.00), and less medical cost (311±20 thousand yuan vs. 347±80 thousand yuan, P=0.00). Independent predictors of ERAS failure were poor preoperative heart function and elevated B-type natriuretic peptides. Conclusion ERAS protocol is feasible and effective in patients undergoing TAVI. Poor preoperative heart function is an independent predictor of failure in early extubation which, in turn, is associated with prolonged ICU and hospital stay and dramatic worsening of patient outcomes.

      Release date:2019-09-18 03:45 Export PDF Favorites Scan
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  • 松坂南