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Tianjin Chest Hospital Completes the First Apical TAVI Surgery in Tianjin

Tianjin Chest Hospital Completes the First Apical TAVI Surgery in Tianjin

  • Categories:News Channel
  • Author:
  • Origin:
  • Time of issue:2018-03-30 09:30
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(Summary description)

Tianjin Chest Hospital Completes the First Apical TAVI Surgery in Tianjin

(Summary description)

  • Categories:News Channel
  • Author:
  • Origin:
  • Time of issue:2018-03-30 09:30
  • Views:
Information

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  Wonderful review
  On March 25, 2017, under the leadership of Director Jiang Nan and Director Chen Qingliang of the Department of Cardiology, Tianjin Thoracic Hospital, the Tianjin Thoracic TAVI team successfully completed the first minimally invasive aortic valve replacement (TAVI) in Tianjin. Jie Cheng Medical will bring a wonderful review of the surgery.
  Patient introduction
  The 76-year-old grandfather Xu came to the chest hospital in April due to chest tightness and chest pain. After a detailed examination by the heart team, he diagnosed severe aortic valve insufficiency. At the same time with coronary artery stenosis, high blood pressure grade 3 (very high risk), chronic obstructive pulmonary disease, grade 2 diabetes. After evaluation by the expert team, the surgical risk of surgical resection of the aortic valve was high, and the STS (heart surgery risk assessment) score reached 8 points or more (total score 10 points). The risk of death is high. After discussion by a team of experts, it was decided to use the latest interventional valve technology, J-Valve, to treat Grandpa Grandpa.
  J-valve is a team led by Dr. Zhang Ji, a Canadian returning expert who was selected into the National Thousand Talents Program. After more than ten years of research and development, he created innovative medical devices. As a representative project of China's scientific and technological community, it was astoundingly debuted at the G20 summit.
  Dr. Bo Bo from the Department of Cardiology introduced that, compared with traditional thoracotomy, the J-Valve Valve Replacement Technology product is a "precise activity positioning device heart valve implantation system." This is a minimally invasive surgical technique and product. Compared with traditional heart valve disease treatment methods, it does not require thoracotomy and no need for extracorporeal blood circulation, which can greatly reduce the patient's surgical trauma, shorten postoperative recovery time, reduce patient's pain and reduce the patient's physical condition requirements. To expand the scope of the disease, improve the effectiveness of treatment, reduce the cost of surgery, so that the majority of patients need to replace the heart valve can be treated.
  Before surgery, under the chairmanship of Jiang Nan, the Department of Cardiology, Cardiology, Anesthesiology, Ultrasound, Imaging, and Operation of Tianjin Chest Hospital had undergone multiple preoperative discussions and CT evaluations and decided to use a 27 mm J-valve valve. Apical TAVI for Grandpa Grandpa.

 

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  Surgical procedure
  Operation time: March 25, 2018

 

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  (Preoperative preparation, nervous and orderly)
  Surgical procedure (1): Take a supine position, routinely disinfect the shop towel, venous compound general anesthesia, and puncture the left iliac artery to monitor blood pressure. The right femoral vein was punctured and a temporary pacing lead was implanted into the right ventricular apex.

 

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  (Jiang Nan, director of surgery)
  Surgical procedure (2): Puncture the right femoral artery and place a 6F pigtail catheter into the aortic sinus and monitor the aortic blood pressure. The C-arm position was adjusted based on the previous CT measurement data so that the three valve sinuses were displayed at the same time and in the same plane. Make a left thoracic incision, open the pericardium, suture the heartpoint, and set aside 6 shims. After the apical puncture, a j-tip soft guide wire was implanted into the ascending aorta, and a guide wire was inserted into the JR4 guide catheter. Guide the guidewire to the distal end of the descending aorta. Replace 1.8m super-slip hardened steel wire. Remove the JR4 catheter.

 

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  (Director Chen Qingliang during surgery)
  Surgical procedure (c): Combining preoperative CT and echocardiographic measures of the diameter of the annulus, a 27 mm J-valve valve was assembled and delivered along the stiffened guidewire to the valve delivery system equipped with the valve above the aortic valve plane.
  (Video 1)

 

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  Surgical procedure (4): assistance in positioning of the pig's tail catheter, assisting the guidance of aortic root angiography to release the positioning part, ensuring that the positioning part is in the native valve sinus, lowering the valve to the annulus plane, opening the valve stent, and releasing the stent after the stent is released System, aortic root angiography of the pig tail catheter showed that the prosthetic valve was in a proper position, opening and closing was well, the coronary artery opening was unaffected, and there was no valve leakage and regurgitation. TEE and aortic root angiography showed that the mitral valve opening was not affected and the artificial aortic valve worked well. No valve leakage at all, very successful!
  (Video 2)

 

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  The valvular puncture release process took less than 10 minutes to complete, and the entire procedure took 2 hours, which saved a lot of time compared to conventional surgery and also eliminated the risk and pain of chest opening.
  Post-surgery epilogueAfter the operation, Mr. Xu Lao recovered well. Four hours later, he removed the endotracheal intubation, returned to the general ward, started rehabilitation training, and was ready for discharge on March 29.
  The surgical experts all said that the leading design of the j-valve aortic valve and the implant system made the entire operation rapid, the valve positioning accurate, the operation of the implanter simple and clear, and the postoperative results satisfactory.The J-Valve artificial interventional biovalvular heart valve is a new generation of intervening valve. It was approved for clinical use by the State Food and Drug Administration in April 2017. It is currently the world’s only officially approved intervention to treat aortic stenosis and insufficiency The valve is also a one-stop solution for aortic valve disease.

 

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