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epartment of Cardiology, Union Hospital, Fujian Medical University successfully completed the first TAPI operation in Fujian Province

epartment of Cardiology, Union Hospital, Fujian Medical University successfully completed the first TAPI operation in Fujian Province

  • Categories:News Channel
  • Author:
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  • Time of issue:2018-01-08 11:23
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(Summary description)

epartment of Cardiology, Union Hospital, Fujian Medical University successfully completed the first TAPI operation in Fujian Province

(Summary description)

  • Categories:News Channel
  • Author:
  • Origin:
  • Time of issue:2018-01-08 11:23
  • Views:
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  ▌ On January 7, 2018, the Cardiac Surgery Team headed by Professor Chen Liangwan successfully completed the first transvaginal aortic valve implantation (TAVI) operation in Fujian Province. The entire operation took only 1 An hour, 6 hours after surgery patients can eat. Professor Chen Liangwan is pleased to say that this new technology provides a new and effective minimally invasive treatment for patients with aortic valve disease and will certainly benefit more patients. Jiecheng Medical will bring a wonderful review of surgery.

 

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  Patient history data

  ▌ chief complaint: chest tightness after the event, shortness of breath more than 10 years, increased with cough for 1 week.
  ▌ admission diagnosis: rheumatic heart disease: aortic stenosis with incomplete closure, mitral regurgitation, heart function Ⅲ, pulmonary infection, hypertension 3 (very high risk), diabetes.
  Superfluous ultrasonography: aortic valve calcification, stenosis (severe) with regurgitation (severe regurgitation), mitral valve calcification with mild regurgitation, mild tricuspid regurgitation with pulmonary hypertension (mild) EF73.1%.

 

  Surgical strategy

  Accurate assessment of cardiac CT by cardiac surgery team: The aortic valve is of trilobal type with large valve leaflets and thickening of the valve, with moderate-severe calcification. Uneven calcification distribution of the left ventricular outflow tract relative to the annulus was significantly narrower circumference of the aortic annulus diameter conversion 21.15mm, the discussion decided to use 21mm J-Valve? interventional valve transapical TAVI surgery.

 

  Surgical procedure

  ▌ surgery time: January 7, 2018.

  ▌ surgical procedures (a): take the supine position, conventional disinfection shop towel, intravenous composite anesthesia, puncture the left radial artery to monitor blood pressure. Puncture the right internal jugular vein and implant the temporary pacing lead to the apex of the right ventricle.

  ▌ surgical procedure (b): puncture the right femoral artery 6F pig tail catheter into the aortic sinus, and monitoring of aortic blood pressure. According to the previous CT measurement data to adjust the position of the C arm so that the three valve sinus simultaneously displayed and in the same plane. Do a left chest incision, open the pericardium, apex purse suture, and set aside 6 pads. J-tip soft guide wire was implanted into the ascending aorta after apical puncture. The guide wire was inserted into the JR4 guide catheter and the guide wire was guided to the distal end of the descending aorta. The 1.8 m ultra-slip stiffening wire was replaced and the JR4 catheter was removed.

 

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  Surgical Procedures (C): Combining preoperative CT and ultrasonographic measurements of valve annulus size, a 21 mm J-Valve? valve is assembled along the stiff guide wire into a valve-equipped catheter delivery system above the plane of the aortic valve.

 

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  ▌ surgical procedures (D): pig tail catheter assisted positioning, aortic root radiography to assist the release of the positioning guide to ensure that the positioning member is located in the autologous valve sinus, the valve down to the annulus plane, open the valve stent, the stent after the release of catheter delivery System, pig tail catheter aortic root angiography showed: artificial valve position, open well, the coronary ostial was not affected, no paravalvular leakage and reflux. TEE and aortic rootography showed mitral valve opening and closing is not affected, artificial aortic valve works well.

 

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  surgical procedures (D): pig tail catheter assisted positioning, aortic root radiography to assist the release of positioning guidance, to ensure that
  Conclusion

  ▌ After the operation was completed, Professor Chen Liangwan said that the leading design of J-Valve? aortic valve and implant system has enabled the entire operation to be completed smoothly and quickly. The accurate positioning of the valve and the simple and convenient operation of the implantation result are satisfactory. .

  The J-valve? Interventional Bio-heart Valve is a new generation of interventional valves that was approved for clinical use by the State Food and Drug Administration in April 2017. Its indications include aortic valve stenosis, aortic regurgitation and aortic valve stenosis Closure of the incomplete, is currently the world's only officially approved to treat aortic valve regurgitation interventional valve, but also a one-stop solution of aortic valve disease. The position of the valve is in the native valve, the valve is lowered to the plane of the valve annulus, the valve holder is opened, the stent is released, and the catheter delivery system is released. The pig tail catheterization shows the aortic root angiography: the position of the prosthetic valve is proper, the opening and closing are good, Affected, no paravalvular leaks and reflux. TEE and aortic rootography showed mitral valve opening and closing is not affected, artificial aortic valve works well.

 

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