Ms. Chen (pseudonym), 77 years old
Suddenly felt shortness of breath some time ago.
Originally, she thought it was not a big problem.
I didn't expect two weeks to pass.
The condition of shortness of breath is not improving.
Seeing that the situation is getting worse.
The family hurriedly took Ms. Chen to the emergency department of Foshan Second Hospital.
After completing the relevant inspections.
Consider Ms. Chan to have acute heart failure.
Admitted to the Department of Cardiology**.
Detailed examinations are carried out during hospitalization.
and a series of cardiac function assessments.
It was determined that Ms. Chen had severe aortic stenosis with moderate regurgitation.
The aorta is like one.
The "big pipe" that transports blood
Once narrowed, the blockage does not flow.
The problem can be big or small.
This is a serious heart condition.
It can pose a significant threat to the health and life of patients at any time!
The medical staff immediately gave Ms. Chen symptomatic medication**, but after **, Ms. Chen's heart failure symptoms did not improve significantly.
Faced with this situation.
The Department of Cardiology invited the Department of Cardiothoracic Surgery, Anesthesiology, Ultrasound, and Critical Care Medicine to conduct a multidisciplinary consultation (MDT).
Finally suggested Ms. Chen.
Transcatheter aortic valve replacement (T**R) is performed
It is a minimally invasive procedure that offers new hope for patients who are at high risk of this surgical procedure and cannot undergo surgery. This procedure delivers the artificial heart valve through the blood vessel to the aortic valve position of the heart, and successfully expands or releases the valve into the correct position, solving the problem of severe aortic stenosis and insufficiency of the aortic valve.
However, due to Ms. Chen's older age and multiple underlying medical conditions, the risk of surgery is relatively high. After many in-depth exchanges and discussions with the patients and their families, the team of Director Liang Jianqiu of the Heart Center decided to face the difficulties and carry out the operation.
Although they had expected the risks, the surgical team did not expect that the first hurdle would come so quickly - on the day of the operation on February 8, during the preoperative preparation stage, Ms. Chen began to develop ventricular fibrillation, a serious arrhythmia that can quickly threaten her life. Seeing this, the medical staff immediately took emergency measures and repeatedly performed defibrillation for Ms. Chen, and after several nervous defibrillations, Ms. Chen's condition was finally relatively stable and she could continue the operation.
However, at a critical moment in the operation, when the valve was released, Ms. Chen's heart suddenly stopped beating.
At this critical moment, Director Liang Jianqiu's team judged that the cardiac arrest was caused by a large amount of valvular regurgitation, and decisively decided to release the valve on the premise of ensuring accurate valve positioning.
After the release, the valve position was normal, the regurgitation disappeared, Ms. Chen's heart successfully resumed beating, there was no ventricular fibrillation, and her blood pressure gradually stabilized!
At the critical moment of the operation, Director Liang Jianqiu showed rich experience and excellent clinical judgment ability, and successfully completed the operation in the critical state of cardiac defibrillation more than 10 times and cardiac arrest, showing the tacit cooperation of the heart center team.
The operation was successful, and the medical staff present were relieved. With the support of close post-operative monitoring and careful care, Ms. Chen's condition improved day by day and she was discharged from the hospital on 17 February!
T**r surgery is well known
Aortic stenosis prevents blood from the left ventricle from being pumped to the aorta effectively, causing heart failure, angina pectoris, and even sudden death.
In the past, the solution was to open the chest and change the flap, which sounded creepy.
Transcatheter aortic valve replacement (T**R) allows a prefabricated bioprosthetic valve to be precisely implanted into the aortic valve through a single catheter, replacing the decaying in-situ valve with an artificial valve.
Approximate procedure of the operation:
Catheterization: Under general or local anesthesia plus sedation, a catheter is inserted from the femoral artery in the thigh (or sometimes from the artery in the chest) and guided to the heart.
Valve positioning: Through a catheter, a folded prosthetic valve is delivered to the position of the aortic valve. This valve is usually attached to a special scaffold called a stent valve.
Dilatation and release: In the correct position of the heart valve, a balloon (dilator) or self-dilating mechanism is used to release and gently push the damaged valve open. The prosthetic valve is then released, allowing it to expand and fit snugly in place of the original valve.
Check and end the procedure: Once the valve is released, the position and function of the new valve is checked by ultrasound or other imaging techniques to confirm that it is working correctly and that there is no blood leakage. Once everything is confirmed, the catheter is removed and the surgery is complete.
This surgery does not open the thoracotomy and has the advantages of less trauma and faster recovery. The development of T**R technology has given more options to patients with severe aortic stenosis who are elderly, have many comorbidities, poor cardiac function, and cannot tolerate thoracotomy and cardiopulmonary bypass surgery, giving them hope for life.
In recent years, the Heart Center of Foshan Second People's Hospital has successfully completed more than 30 cases of transcatheter aortic valve replacement (T**R) and has become the construction unit of Guangdong Valve Alliance. The cardiology team led by Liang Jianqiu, director of the Heart Center, has been innovating in this field, scaling new heights, filling the gaps in relevant technologies in provinces and cities, and bravely challenging the majority of patients with valvular disease.