中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

70 例心尖入路经导管主动脉瓣植入术病例的麻醉管理

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目的 探讨心尖入路经导管主动脉瓣植入术的麻醉要点。 方法 通过回顾性分析华西医院心脏大血管外科从 2014 年 3 月至 2015 年 10 月间共完成的 J-Valve 经心尖 TAVI 手术 70 例的麻醉资料,总结该类手术围手术期的准备及麻醉要点。 结果 纳入的 70 例患者相对年龄较大,合并症较多,如缺血性心脏病,高血压,糖尿病甚至中风,手术风险较高。其中主动脉瓣狭窄患者 39 例,反流 31 例,无 1 例死亡。术后随访手术成功 67 例,成功率达 95.7%。 结论 经心尖 TAVI 手术患者麻醉在一些细节方面需要更多的关注,需要整个心脏团队医生对手术步骤有全面的认识,通力合作,确保患者围术期安全。

Objective To discuss the key points of anesthesia for patients undergoing transcatheter aortic valve implantation (TAVI) surgeries. Methods We retrospectively collected and analyzed the data of 70 patients underwent TAVI in the department of cardiovascular surgery, West China hospital from March, 2014 to October, 2015. Results All of the 70 included patients were aged and at high risk with significant comorbidities such as ischemic heart disease and stroke. The aortic stenosis and regurgitation cases accounted for 39 and 31 respectively. No patients died during the surgery. The total success rate was 95.7%. Conclusion TAVI is a complex procedure for high risk patients and need more attention during anesthesia. The successful conduction of the procedure requires the whole team to prepare carefully and corporate closely.

关键词: 心尖入路; 经导管主动脉瓣植入术; 麻醉管理

Key words: Transapical; transcatheter aortic valve implantation; anesthesia management

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