Analysis Of Short-term Effects Of Transcatheter Aortic Valve Replacement In Patients With Simple Aortic Regurgitation

Objective This study aimed to collect and analyze the short-term effects of transcatheter aortic valve replacement in patients with simple aortic regurgitation.To evaluate the effect and safety of this technique in patients with simple aortic regurgitation,and to provide ideas for selecting more appropriate surgical methods in the future.Methods Retrospective cohort study.59 patients with aortic disease who were hospitalized in the Department of Cardiovascular Surgery,the First Affiliated Hospital of Anhui Medical University from January 2021 to December 2022 were selected and received TAVR treatment,including 32 males and 27 females,aged 72.0(69.0,76.0)years old.European cardiovascular score II 2.9(2.3,4.9)points.BMI 22.4±3.5kg/m~2。The average follow-up period was 6.9 months.Among 59 patients,there were 3 cases of simple aortic valve stenosis,34 cases of aortic valve stenosis with aortic valve insufficiency,and 22 cases of simple aortic valve insufficiency.The cardiac function rating of 59 patients was gradeⅢin 54 cases and gradeⅣin 5 cases;Among the 59patients,8 had preoperative atrial fibrillation,47 had cerebrovascular disease,29 had coronary heart disease,and 36 had pulmonary disease.There were 9 cases of cardiac surgery,8 cases of smoking and 7 cases of drinking in the past.All patients were diagnosed by transthoracic echocardiography before operation,and the examination was completed.Relevant departments were consulted to assist in diagnosis and treatment.After the patient’s condition was stable and there was no contraindication for operation,TAVR surgery was performed.To compare the TAVR treatment of patients with simple aortic regurgitation and those with aortic stenosis,evaluate the safety of the technique and analyze the short-term effect after operation.Observation indicators:(1)Observe the clinical baseline data of patients in different groups;(2)Observe the intraoperative condition of all patients,the operation time,the mechanical ventilation time of CICU,the retention time of CICU,the postoperative hospitalization time,the total number of days in hospital,and the occurrence of postoperative complications;(3)The operation time,CICU mechanical ventilation time,CICU retention time,postoperative hospitalization time and total hospitalization days of patients in different groups were compared,and the indexes of echocardiogram and postoperative complications were compared one week after operation;(4)Follow up the echocardiographic results of the patients regularly after the operation,and ask whether the patients’symptoms are better than those before the operation.Results The cardiac function(NYHA grade)of the patients during the postoperative hospitalization was below gradeⅡ,and the cardiac color Doppler indexes were significantly improved,including LA4.7±0.7cm,LV6.1±1.1cm,EF52.0(38.0,60.0)%,and aortic valve cross-valve pressure 43.0(23.0,52.0)mm Hg.27 patients with moderate or above mitral regurgitation,2 patients with permanent pacemaker implantation during hospitalization,6 patients with new postoperative atrial fibrillation,22 patients with slight perivalvular leakage,7 patients with mild perivalvular leakage,and 2 patients with mild and moderate perivalvular leakage.During the follow-up period,there was no death,no moderate or more perivalvular leakage,and the patient’s cardiac function was significantly improved.In this study,all patients successfully completed the operation,and were divided into two groups according to whether or not they were complicated with aortic valve stenosis:stenosis group and simple insufficiency group.There was no significant difference between the two groups in operation time,CICU mechanical ventilation time,CICU retention time,postoperative hospital stay,and total hospital days(P>0.05).The echocardiographic indexes and postoperative complications were reviewed one week after the operation.There was no significant difference between the two groups in LA,EF,transvalvular pressure,mitral regurgitation rate of moderate or above,new incidence of stroke,atrioventricular block rate,mild or above perivalvular leakage rate,and permanent pacemaker implantation rate(P>0.05).The rate of new atrial fibrillation in the stenosis group was significantly lower than that in the simple insufficiency group(P<0.05).The LV in the stenosis group was significantly smaller than that in the simple insufficiency group(P<0.05).Conclusion Transcatheter aortic valve replacement can significantly improve the cardiac function of patients after operation.It is a good choice for the treatment of aortic valve disease.It is also safe and effective to perform TAVR in patients with simple aortic valve insufficiency.This operation can improve the quality of life of patients after operation.