关键词: 主动脉瓣狭窄, 经导管主动脉瓣膜植入, 主动脉瓣膜置换

Abstract: ［Abstract］ObjectiveTo evaluate the safety and efficacy of transcatheter aortic valve implantation(Tavi) and conventional aortic valve replacement in patients with high risk factors.
〖WTHZ〗MethodsA retrospective analysis of 80 patients with aortic stenosis was carried out. The patients were divided into conventional group(47 cases), small incision group(18 cases) and Tavi group(15 cases). The conventional group was treated with conventional open thoracic aortic valve replacement, the small incision group was treated with upper sternum small incision aortic valve replacement, and the Tavi group was treated with general anesthesia without cardiopulmonary bypass. The operative effect and complications of the three groups were compared.
〖WTHZ〗ResultsThe drainage volume in 24 h in the small incision group was significantly lower than that in the conventional group(P＜0.01). There was no significant difference in blocking time between conventional group and small incision group(P＞0.05). The operation time, ventilator-assisted ventilation time and intensive care unit（ICU） stay time in the small incision group were shorter than those in the conventional group, and the intraoperative blood loss was less than that in the conventional group(P＜0.01). The operation time, ventilator-assisted ventilation time and ICU stay time of TAVI group were shorter than those of conventional group and small incision group, the intraoperative blood loss was less than that of conventional group and small incision group, the mean artery pressure（MAP） change value was greater than that of conventional group and small incision group, and the hospitalization cost was higher than that of conventional group and small incision group(P＜0.05 or P＜0.01). There was no significant difference in the incidence of complications among the three groups(P＞0.05).
〖WTHZ〗ConclusionTavi is more safe, less trauma, less complications and faster recovery than conventional aortic valve replacement in the treatment of patients with high risk factors.

Key words: aortic valve stenosis, transcatheter aortic valve implantation, aortic valve replacement