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find Author "ZHANG Jieqiong" 1 results
  • Short-term results of transcatheter aortic valve replacement converted to surgery

    ObjectiveTo analyze the recent clinical results of emergency conversion of transcatheter aortic valve replacement (TAVR) to surgery, and summarize the clinical experience. Methods The clinical data of patients who underwent TAVR emergency conversion surgery in the Department of Cardiovascular Surgery of the Second Hospital of Hebei Medical University from 2018 to 2023 were collected, and the results of 1-month follow-up after surgery were recorded. Results Totally 253 patients underwent TAVR, and 11 patients underwent emergency conversion to surgery, with an emergency conversion rate of 4.3%. Among the 11 patients, 7 were males and 4 were females, with an average age of 69.55±5.01 years. The causes of urgent conversion to surgery in TAVR were valve stent displacement (63.6%), left ventricular perforation and rupture (18.2%), and a large amount of perivalvular reflux (18.2%) after the insertion of the second valve. One patient died intraoperative, with a perioperative mortality rate of 9.1%. Among the 10 surviving patients, 8 had pulmonary infection, 7 severe pneumonia, 3 pleural effusion, 8 liver function injury, 3 renal function injury, 5 upper gastrointestinal bleeding, 1 cerebrovascular complications, 1 atrial fibrillation, 1 ventricular premature contraction, 1 atrioventricular block, and 3 complete left bundle branch block. After one month of postoperative follow-up, one patient died. The 30-day mortality rate after TAVR emergency conversion surgery was 18.2%, and the quality of life of 9 patients (81.8%) improved significantly compared to before surgery. There were no readmission patients with cardiovascular system diseases. Conclusion The incidence of emergency conversion to surgery in TAVR is low, but the incidence of surgical complications is high, and the 30-day postoperative mortality rate is also high. When severe complications occur during TAVR surgery, emergency conversion to surgical surgery can still bring good early clinical results for most patients.

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