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Guangdong Provincial People's Hospital, the first case of admission: the apex aortic valve replacement treatment of severe aortic stenosis and insufficiency

Guangdong Provincial People's Hospital, the first case of admission: the apex aortic valve replacement treatment of severe aortic stenosis and insufficiency

  • Categories:News Channel
  • Author:
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  • Time of issue:2017-09-30 14:01
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(Summary description)

Guangdong Provincial People's Hospital, the first case of admission: the apex aortic valve replacement treatment of severe aortic stenosis and insufficiency

(Summary description)

  • Categories:News Channel
  • Author:
  • Origin:
  • Time of issue:2017-09-30 14:01
  • Views:
Information

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  ▌J-Valve? is China's first original and has an international leading intellectual property involved in heart valves. Is currently the world's only effective minimally invasive treatment of aortic insufficiency or stenosis of the product. September 28, 2017, Guangdong Provincial People's Hospital, Guo Huiming team for a severe aortic stenosis and incomplete patients J-Valve? by apex aortic valve replacement surgery, which is the first case of Guangdong Provincial People's Hospital admitted to hospital , We will bring you a wonderful review of surgery.

 

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  Patient history data
  ▌ patient male, 78 years old
  Complaints: repeated due to more than 6 months hospitalized, admitted to hospital after repeated heart failure, has been transferred to CCU rescue;
  Admission diagnosis: aortic stenosis (severe) and closed incomplete (moderate);
  Heart ultrasound color: M type method measured EF 49%, Simpson method measured EF38%. Aortic valve diameter of 23mm, mitral regurgitation, color beam area of 3.9cm, aortic regurgitation, color beam area of 5.4cm.
  Surgical strategy
  TA-TAVR;
  Valve selection: 23mm J-Valve? aortic valve;
  Anesthesia.
  Surgery process
  ▌ operation time: September 28, 2017
  ▌ intraoperative diagnosis: aortic valve degeneration, moderate reflux and severe stenosis, mild mitral regurgitation, left atrial enlargement, left ventricular systolic and diastolic dysfunction.
  ▌ Surgical procedure:
  1. Take the supine position, conventional disinfection shop towel, intravenous composite general anesthesia, puncture the left radial artery to monitor blood pressure. Puncture the right femoral vein, implant the temporary pacing wire to the right ventricular apex.
  2. Puncture the right femoral artery into the 6F pig tail catheter to the aortic sinus and monitor the aortic blood pressure. Adjust the position of the C-arm so that the three flaps are simultaneously displayed and located on the same plane. Do left chest incision, open the pericardium, apical purse suture, and set aside 6 gaskets. After the apical puncture, the j-tip guide wire was inserted into the ascending aorta and the 14F arterial sheath was inserted into the J-tip guide catheter via the guidewire. Guide the guide wire to the distal end of the descending aorta. Replace 1.8m oversize plus hardened wire. Remove the J-tip catheter. ▼

 

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  3. Feed the balloon along the guide wire to determine the balloon position in place after rapid pacing ventricular rate 160 times, SBP 50mmHg when the balloon expansion. ▼

 

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  4. Combined with preoperative CT and cardiac overshoot of the diameter of the valve ring, assembled a good 23mm J-Valve? valve, with a hard guide wire into the valve delivery system to the valve aortic valve delivery system above the plane. ▼

 

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  5. In the pig tail catheter to help locate the aortic root angiography to help guide the release of positioning under the guidance to ensure that the positioning part is located in the autologous ventral sinus, lowering the valve to the valve ring plane, open the valve stent, stent release after the catheter delivery system, pig tail Catheter aortic root angiography showed: artificial valve position appropriate, opening and closing good, coronary artery opening is not affected, no valve leakage and reflux. TEE and aortic root angiography showed mitral valve opening and closing was not affected, artificial aortic valve work well.
  Surgical summary
  ▌ after the end of the operation, the participating experts said that the entire operation process quickly and accurately, the results are very satisfactory, good shape of the valve, no half-week leakage, no reflux, the patient blood pressure, signs good.
  ▌J-Valve? artificial interventional biological heart valve is a new generation of interventional valve, in April 2017 access to the State Food and Drug Administration approved clinical use, the indications include aortic stenosis, aortic valve insufficiency and aortic stenosis Merger is not complete, is the only one in the world to obtain official approval to treat aortic valve insufficiency of the interventional valve, but also aortic valve disease one-stop solution.

 

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