| Objective: The incidence of valvular heart disease is on the rise with the increase of people’s life span.in the united states,surgical and pathological results showed that calcified aortic stenosis was the most common,accounting for about 51%,and the stenosis caused by the etiology of lobular valve and rheumatic valve accounted for 36%and 9%,respectively.the incidence rate was 2%-7% in people over 65 reported abroad,and 4.6% in people over 75.studies have shown that the annual survival rate of patients with severe aortic stenosis with fertility symptoms is only 15%～50%.China’s aging population is increasing,the number of aortic valve disease is also increasing.In particular,the incidence of aortic degeneration represented by the proliferation of valve fibers and the change of valve fiber mucus is increasing.The proportion of rheumatic valvular disease in patients with aortic valve disease is also high.At present,there are no specific drugs to treat aortic valve disease,and aortic valve replacement surgery is still an effective method for the treatment of aortic valve disease.With the clinical application of TAVI,the comparison of SAVR and TAVI efficacy has become the focus of attention of cardiac surgeons at home and abroad.Therefore,we have carried out this study,hoping to provide theoretical basis for cardiac surgeons to choose the application of two surgical procedures in clinical work.Methods: Retrospective study of patients with aortic valve disease who received SAVR or TAVI treatment in cardiac surgery at qingdao university affiliated hospital from june 2016 to december 2019 was approved by the medical ethics committee of our hospital.all patients signed informed consent before operation.Results: Overall,40 patients were eligible for inclusion,of which 23 received SAVR treatment and 17 received TAVI treatment.SAVR group of patients were treated with general anesthesia,the average operation time was(3.91±0.2)hours,and the time of intensive care treatment was(6.6 ±1.3)days after operation.average postoperative hospital stay(14.7 ± 1.5)days.TAVI group of patients were treated with general anesthesia,5(29.4%)operated through the apical approach and 12(70.6%)through the femoral artery.average operation time was(2.05±0.28)hours,and the time for intensive care treatment after operation was(4.2±1.1)days.average postoperative hospital stay(11.8±1.8)days.SAVR group had 6 stroke(26.1%),10 myocardial infarction(43.5%),5atrial fibrillation(21.7%),2 permanent pacemaker implantation(8.7%),10 acute kidney injury(43.5%)and 4 death due to surgery-related causes(17.4%).During the follow-up period,3 patients in the TAVI group developed stroke(17.6%),5 developed myocardial infarction(29.4%),5 developed atrial fibrillation(29.4%),1 underwent permanent pacemaker implantation(5.9%),7 developed acute kidney injury(41.2%),and no patients died from surgery-related causes(0%).Conclusion: TAVI and SAVR in the clinical practice of treating aortic valve disease,the operation time of TAVI is shorter,and the time of postoperative intensive care treatment and hospitalization is shorter.in the comparison of postoperative complications,there was no statistical difference in the probability of postoperative stroke,postoperative myocardial infarction and postoperative atrial fibrillation between the two groups.but the mortality rate in SAVR group was significantly higher than that in TAVI group.hence,to sum up,TAVI treatment of aortic valve disease is more effective and worthy of clinical application. |
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