The second generation of recyclable valves benefited patients by replacing the aortic valve without thoracotomy

2022-09-23 0 By

(the correspondent Yang cen Liu Xiaoxiong) on February 10, only a 2 cm hole in the leg, he successfully replace cardiac aortic uncle zhang, came to wuhan university people’s hospital heart II division (coronary heart disease specialist) professor Yang Bo appointment, results showed he was acute left heart failure, heart function has returned to normal.Two months ago, Uncle Zhang, who lives in Ezhou, Hubei province, appeared paroxysmal dyspnea, and his activity tolerance decreased significantly. He was always strong and did not take it to heart.A few days later, he fell into a coma due to respiratory distress and excessive sweating. His family rushed him to a local hospital for emergency treatment.After surviving in the INTENSIVE care unit, panicked Mr. Zhang went to the Cardiology department of Wuhan University People’s Hospital (Hubei Provincial People’s Hospital), where he was diagnosed as “acute left heart failure, severe aortic insufficiency, and grade III cardiac function”.Patients with severe aortic insufficiency routinely undergo aortic valve replacement.After hearing that the Department of Cardiology of The People’s Hospital of Wuhan University can carry out minimally invasive transcranial aortic valve replacement (TAVR), zhang decided to try a new one.After detailed examination, the doctor found that the big ye is a minimally invasive indications of transcatheter aortic valve replacement, but he was short of left ventricular outflow tract, only 3.5 mm, can only rely on disc ring and disc ring under 2-3 mm outflow to the anchor, the valve is released the fault-tolerant rate is low, once the valve declines, release the position error can seriously affect the function of mitral valve,This poses a considerable challenge for doctors.Jiang Hong, director of the Cardiology Department of the hospital, organized the ultrasonography department, anesthesiology Department, radiology department and cardiac surgery department to form an MDT treatment team for repeated discussion and study, and determined the surgical plan: valve replacement surgery with the second-generation recoverable valve.Unlike the first-generation valve, which was released irreversibly, the second-generation valve’s recyclable function allows for trial and error, allowing the surgeon to correct errors repeatedly until the valve is in perfect position.Before surgery, Professor Xia Hao explained surgical procedures and gave psychological support to patients and their families in detail.After making sufficient plans, director Yang Bo and Professor Zeng Bin of the department of Cardiology II, director Jiang Hong of the Department of cardiology and Director Chen Jing of the Department of cardiology ⅴ, took Uncle Zhang’s thigh as a catheter approach to deliver the artificial heart valve to the aortic valve.During the operation, in order to achieve accurate positioning, the medical team first released the valve to 75%, and determined the position of the valve and the presence of perivalvular leakage through esophageal ultrasound and angiography. After two attempts, the valve was accurately released to the calibration position, and the heart valve implantation was successfully completed.Postoperative ultrasound and other image evaluation showed that grandpa Zhang’s valve replacement and valve stent were in good position, without regurgitation and perivalvular leakage. The size and function of left heart were significantly improved compared with that before surgery, and cardiac function and other indicators recovered well.After the operation, under the careful treatment of Professor Zeng Bin and Dr. Liu Xiaoxiong, Uncle Zhang was able to get out of bed soon and spend a happy Spring Festival at home without any symptoms such as dyspnea.Patients with severe aortic insufficiency or stenosis can have their heart valves replaced by minimally invasive transcatheter aortic valve replacement (TAVR), Yang said.Compared with traditional thoracotomy for valve replacement, this method has the advantages of less trauma, no need to establish extracorporeal circulation and fast postoperative recovery, and is suitable for patients with heart valvular disease who cannot tolerate surgery and do not want to undergo surgical thoracotomy.It is reported that the Department of Cardiovascular Medicine of The People’s Hospital of Wuhan University is a national key discipline and a national key clinical specialty, and has been selected into the National Difficult cardiovascular Disease promotion Project.In recent years, under the leadership of Director Jiang Hong, we have actively carried out various internationally leading high-risk complex cardiac interventional surgeries to save a large number of complex heart disease patients in a minimally invasive way.