Protective effect of J-Valve transapical aortic Valve replacement in patients with aortic stenosis with low coronary ostium
10.3760/cma.j.cn112434-20220822-00278
- VernacularTitle:使用J-Valve瓣膜经心尖导管主动脉瓣置换对低冠状动脉开口主动脉瓣狭窄患者的保护作用
- Author:
Quanhui XU
1
;
Haibo ZHANG
;
Zhenzong DU
;
Yuehuan LI
;
Jinglun SHEN
;
Kaisheng WU
Author Information
1. 广西壮族自治区南溪山医院心脏大血管外科，桂林 541002
- Keywords:
Transcatheter aortic valve implantation;
Aortic stenoosis;
Apex;
Low coronary ostium
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(10):594-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of J-valve transapical catheter aortic Valve replacement(TA-TAVI) in the early treatment of aortic stenosis with low coronary ostium.Methods:From January 2020 to April 2022, 20 patients with aortic stenosis with coronary opening height ≤10 mm who underwent TA-TAVI treatment in the Valve Surgery Center of Beijing Anzhen Hospital Affiliated to Capital Medical University were enrolled retrospectively. All patients underwent preoperative imaging screening, and 5 patients underwent preoperative coronary artery protection: The height of coronary artery opening was less than 5 mm in 3 cases. 2 cases had stent stenosis & LT after coronary artery stenting 50%, and the position of the coronary artery opening was less than 8mm. The postoperative complications, mortality and cardiac function prognosis of TA-TAVI were analyzed.Results:There were 5 males and 15 females. The average age of the whole group was(73.00±6.20) years. Transthoracic echocardiography showed that all patients had severe aortic valve stenosis, and 85% of the patients had NYHA grade Ⅲ-Ⅳ, and 80% of the patients had aortic valve stenosis with insufficiency. The mean height of left coronary artery opening was(9.07±3.70) mm. RCA(11.39±3.00) mm; The opening height of coronary artery was ≤5 mm in 3 cases(left 7.5%), 5-8 mm in 5 cases(12.5%), and 8-10mm in 16 cases(40.0%). Mean aortic sinus(valsalva) diameter: Left(30.06±5.90) mm; Right(28.50±5.68) mm; Non(29.96±6.15) mm. J-valve Valve was successfully implanted through apical catheter in all patients, most of whom were size 23. CPB was performed in 2 patients at the same time, permanent pacemaker was inserted in 2 patients, and moderate or above perivalvular leakage was found in 0 patients. All patients had TNI( P=0.12) and MYO( P=0.03) before and 24 hours after operation. None of the 5 patients underwent coronary artery stenting. None of the 5 patients died within 30 days after the operation. Ta-tavi is effective 30 days after operation, with low complication rate and good prognosis of cardiac function. Conclusion:J-valve transapical catheter aortic Valve replacement is safe and effective in the treatment of aortic stenosis with low coronary ostium.
