Short-term clinical efficacy of one-stop TAVR+PCI in the treatment of patients with aortic valve disease and coronary heart disease
Objective To analyze the short-term clinical efficacy and prognosis of one-stop transcatheter aortic valve replacement(TAVR)+percutaneous coronary intervention(PCI)in the treatment of aortic valve disease with coronary heart disease.Methods The clinical data of patients with aortic valve disease complicated with coronary heart disease who underwent one-stop TAVR+PCI treatment at the Department of Cardiovascular Surgery,the Second Hospital of Hebei Medical University from January 2018 to June 2023 were retrospective analyzed.The preoperative and postoperative clinical data were compared,and 1-month follow-up results were recorded.Results A total of 37 patients were enrolled,including 22 males and 15 females,with an average age of 69.14±6.47 years.Thirty-six patients recovered and were discharged after the surgery,and 1(2.7％)patient died during the surgery.Self-expanding TAVR valves were implanted through the femoral artery in all patients.One coronary artery was opened by PCI in 35(94.6％)patients,and two coronary arteries were opened by PCI in 2(5.4％)patients.All PCI opened arteries had a stenosis＞70％.During the postoperative hospitalization,the complications included pulmonary infection in 11(30.6％)patients,severe pneumonia in 10(27.8％)patients,liver function injury in 14(38.9％)patients,renal function injury in 5(13.9％)patients,cerebral infarction in 1(2.8％)patient,atrial fibrillation in 1(2.8％)patient,ventricular premature beats in 2(5.6％)patients,atrioventricular block in 2(5.6％)patients,and complete left bundle branch block in 5(13.9％)patients.The median postoperative ventilation assistance time was 12.0(0.0,17.0)h,the ICU monitoring time was 1.0(0.0,2.0)d,and the postoperative hospitalization time was 5.0(4.0,7.0)d.There was a significant improvement in the New York Heart Association cardiac function grading after surgery(P＜0.001).After surgery,there were 21(58.3％)patients had minor perivalve leakage,6(16.7％)patients had minor to moderate perivalve leakage,and no moderate or above degree of perivalve leakage.After one month of postoperative follow-up,36 patients showed significant improvement in heart function.There were no patients with recurrent acute coronary syndrome,re-PCI,or cardiovascular system disease related re-hospitalization.Conclusion The one-stop TAVR+PCI treatment for patients with aortic valve disease and coronary heart disease can obtain satisfactory short-term clinical efficacy,which is worth further trying and studying.
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