Xin’an Evening News, Anhui Net, Dawan News News, “I always thought that a major operation like a heart valve replacement would require opening the chest, but I didn’t expect to recover so quickly.” On March 16, 80-year-old grandma Wang recovered and was discharged from the Department of Cardiovascular Medicine, Hefei Second People’s Hospital, Heping Road District. It is reported that this is the first patient in Hefei Municipal Hospital to successfully undergo transcatheter aortic valve replacement surgery.
The 80-year-old grandma Wang has been suffering from chest tightness and asthma for the past 10 years. In the past two weeks, her condition has worsened significantly. In early March, accompanied by his family, the old man came to the Department of Cardiovascular Medicine of Heping Road Hospital for treatment. Cardiac ultrasound showed severe calcification of the aortic valve, severe stenosis with moderate to severe closed regurgitation, and the transvalvular pressure difference was nearly 90 mmHg. The cardiac function was severely damaged. At this time, a new active valve valve should be replaced as soon as possible to effectively improve the condition.
After being admitted to the hospital, after discussion in the department, due to his advanced age, the elderly suffer from various basic diseases such as diabetes, bronchiectasis, and heart failure. At this time, it is too risky to perform surgical thoracotomy for valve replacement. According to the 2021 European guidelines for the management of valvular heart disease and the consensus of relevant Chinese experts, transcatheter aortic valve implantation has become the only treatment method. The hospital’s medical department immediately organized multidisciplinary consultations in the department of anesthesiology, cardiothoracic surgery, interventional catheterization room, ultrasound department, ICU, imaging center, and nursing department. After full evaluation, it was decided to perform transcatheter aortic valve replacement (TAVI) for the elderly.
“Transcatheter aortic valve replacement surgery can significantly improve the condition without cardiopulmonary bypass, sternum sawing, and almost no obvious blood loss. But at the same time, this type of surgery is technically difficult. Any minor mistakes will have catastrophic consequences.” According to Feng Jun, director and chief physician of the Department of Cardiovascular Medicine, Hefei Second People’s Hospital, Hefei Road District, for the patient’s advanced age, many underlying diseases, severe valve calcification, For unfavorable factors such as low coronary ostium, the surgical team, with the strong support and guidance of the provincial hospital and the close cooperation of the imaging center, repeatedly reviewed the imaging data to evaluate possible complications and countermeasures, and based on the patient’s imaging data , 3D printing the valve, and performing in vitro simulation operations.
After sufficient preoperative preparation, the operation officially started at noon on March 10. The hospital’s Department of Cardiology, Department of Anesthesiology, Cardiothoracic Surgery, Department of Ultrasound, ICU, Imaging Center, Interventional Catheterization Laboratory, Nursing Department, etc. Ten departments, through high-quality seamless docking, accurately grasp the timing, deliver the artificial valve through the femoral artery, release the valve after the valve is in place, and expand the artificial valve to replace the original severe stenosis of the aortic valve. The operation was successfully completed in just over 2 hours. . Postoperative re-examination of esophageal ultrasound showed that the valve was in good working condition, and the transvalvular pressure difference decreased from 90mmHg before operation to 10mmHg, and recovered well. The patient was discharged from hospital on March 16th.
According to Director Feng Jun, aortic valve stenosis is one of the most common heart valve diseases in clinic. With the aging of the population, the prevalence rate is increasing year by year. Patients with stenosis have a very high mortality rate. The traditional treatment method is valve replacement under cardiopulmonary bypass, but it is not tolerated by surgery for patients with underlying diseases and elderly patients. The introduction of transcatheter aortic valve implantation (TAVI) has brought new hope to patients with severe valvular heart disease who have lost the opportunity for surgery. As a key specialty of Hefei City, the Cardiology Department of the hospital has three mature sub-specialties. Through continuous accumulation of TAVI technical experience, it has laid a technical foundation for the construction of structural cardiology sub-specialty. The technical breakthrough of transcatheter aortic valve implantation not only It has laid a foundation for better protection of the health of elderly and severe valvular disease patients, and further improved the service capability of Hefei municipal hospitals in the ageing era of interventional medical technology.
Zhu Peiyan, Xin’an Evening News, Anhui Net, Dawan News reporter Ye Xiao
Editor Xu Dapeng