70例心尖入路经导管主动脉瓣植入术患者的麻醉管理  

Anesthesia management for 70 patients with transapical transcatheter aortic valve implantation surgery

作　　者：许钊[1] 邱静萱 朱达[2] 陈玉成[3] 郭应强[2] 倪禾丰[4] 梁鹏[1] XU Zhao;QIU Jingxuan;ZHU Da;CHEN Yucheng;GUO Yingqiang;NI Hefeng;LIANG Peng(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Operating Room,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西医院心脏大血管外科,成都610041 [3]四川大学华西医院心脏内科,成都610041 [4]四川大学华西医院手术室,成都610041

出　　处：《中国胸心血管外科临床杂志》2018年第8期701-706,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨心尖入路经导管主动脉瓣植入术(TAVI)的麻醉要点。方法回顾性分析2014年3月至2015年10月华西医院心脏大血管外科行J-Valve经心尖TAVI手术70例患者的临床资料,其中男39例、女31例,平均年龄(73.7±4.5)岁。总结该类手术围手术期的准备及麻醉要点。结果纳入的70例患者年龄相对较大,合并症较多,如缺血性心脏病、高血压、糖尿病甚至卒中,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） surgery. Methods We retrospectively collected and analyzed the data of 70 patients who underwent TAVI in the Department of Cardiovascular Surgery, West China Hospital from March 2014 to October 2015.There were 39 males and 31 females with an average age of 73.7±4.5 years. The perioperative preparation and anesthesia points of TAVI were summarized. Results All of the 70 included patients were aged and at high risk severe comorbidities such as ischemic heart disease and stroke. The aortic stenosis and regurgitation occurred in 39 and 31 patients 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 cooperate closely.

关 键 词：心尖入路 经导管主动脉瓣植入术 麻醉管理 

分 类 号：R614[医药卫生—麻醉学]