Professor Chen Yuguo’s team from Qilu Hospital of Shandong University completed the highly difficult two-lobed aortic valve TAVI operation for 2 critically ill patients
Recently, professor Chen yuguo and his team from shandong university qilu hospital successfully performed transcranial aortic valve replacement (TAVI) in 2 patients with highly difficult Type1 l-r fusion with bicuspid aortic valve. The patients’ symptoms were significantly relieved and their cardiac function was significantly improved.Case 1: a 72-year-old male was admitted to the hospital with paroxysmal chest tightness and dyspnea, and was unable to lie flat at night.Professor Chen Yuguo’s TAVI team urgently evaluated and prepared the patient for surgery. Preoperative cardiac color doppler ultrasound showed LVEF 0.38, two-lobe aortic valve (TypeI type), aortic valve sclerosis and stenosis (severe).Preoperative CT showed severe calcification of valve leaf (calcification score > 1600 points), ascending aortic aneurysmal dilation (mean diameter: 57mm), and transverse heart position. There was a risk of rupture of ascending aortic aneurysm and a high risk of coronary opening blockage (left coronary opening height: 6.8mm).Case 2: a 61-year-old female was admitted to hospital with dyspnea after activity. Color doppler echocardiography showed that:LVEF 0.39, two-lobed aortic valve (TypeI type), aortic stenosis (severe), severe calcification of valve lobe (calcification score 1300 points) observed on CT, the height of left coronary opening is 12mm, the length of valve lobe is nearly 15mm, there is also a risk of coronary opening blockage, and the patient is complicated with severe obstructive ventilatordysfunction.Surgical operation is risky.Both patients had poor heart function, frequent symptoms of heart failure, two-lobed aortic valve with severe calcification, ascending aortic aneurysmal dilation, low position of coronary artery opening, difficult operation and high risk.Under the guidance of professor yu-guo Chen, emergency department professor chuan-bao li leading TAVI team with the help of a multidisciplinary cooperation, one-stop complete coronary angiography, active protection left coronary artery and femoral artery successfully in the aortic valve, aortic valve of postoperative ultrasonography to drop across the valve differential pressure to 5-10 MMHG, no obvious anti leakage flow and disc week, support form perfect,Cardiac function improved significantly.Cardiac ejection fraction (LVEF) was increased from 38% and 39% to 61% and 71%, respectively. The average hospital stay was shortened 3 days after the operation.With the aggravation of population aging, the incidence of valvular disease is increasing year by year. Compared with traditional surgery, TAVI has been developing continuously for nearly 20 years and has become the first-line treatment for elderly patients with aortic valve disease.Bicuspid aortic valve (BAV) and rheumatic valvular disease are the main causes of aortic stenosis in China.2 vane aortic valve due to the special anatomical structure, uneven with valve calcification severe and leaves, and the size of the valve leaf, asymmetry problem such as disease, merge the ascending aorta, easy to cause the valves in the process of operation in leakage, shift, disc weeks after coronary artery blockages, complications, such as disc ring rupture, aortic dissection, operation difficulty is great, the risk is extremely high.The above two cases of two-lobe aortic valve TAVI surgery show the superb technical level of Professor Chen Yuguo’s TAVI team in Shandong University Qilu Hospital. The TAVI team will continue to innovate and develop to better serve valvular patients in the province and even the whole country.