Li Nana

and 1 more

Objective To investigate the application value of echocardiography in the preoperative evaluation, intraoperative monitoring and postoperative follow-up of patients with aortic valve disease (AVD) receiving transcatheter aortic valve replacement (TAVR). Methods The clinical data of 79 AVD patients who received TAVR from March 2021 to September 2022 at the Cardiology Centre of Yijishan Hospital, Wannan Medical College, were retrospectively analysed. Twenty-six patients with severe aortic stenosis (AS, including those with pure severe AS and severe AS combined with mild aortic regurgitation (AR)) were included in group I, 31 patients with severe AR (including those with pure severe AR and severe AR combined with mild AS) were included in group II, and the remaining 22 patients with AS combined with AR (AS+AR) were included in group III. The patients’ basic data, preoperative comorbidities, preoperative multislice computed tomography (MSCT) assessment of the aortic root, intraoperative conditions, preoperative and 1-month postoperative echocardiographic parameters, and postoperative complications were collected. Results All patients underwent TAVR through the femoral artery, 79 patients were monitored by transesophageal echocardiography (TEE), 2 patients underwent TEE-guided transseptal puncture for retrograde crossing of the valve, and 6 patients underwent valve-in-valve (VinV) implantation. Immediate postoperative evaluation revealed 1 case of moderate paravalvular leakage (PVL), 4 cases of low-to-moderate PVL, 14 cases of low PVL, 8 cases of trace PVL, and 48 cases of no PVL. Comparing the data obtained at 1 month after surgery with preoperative data, for group I, the maximum aortic valve blood flow velocity (AV Vmax) and mean aortic valve pressure gradient (AVPGmean) significantly decreased (P<0.001), the interventricular septal thickness (IVST) and left ventricular (LV) posterior wall thickness (PWT) decreased (P<0.001), and the left ventricular ejection fraction (LVEF) increased (P<0.05); for group II, the effective regurgitant orifice area (EROA), regurgitant volume (RVol) and AR width significantly decreased (P<0.001), and the left ventricular end-diastolic diameter (LVEDD) significantly decreased (P<0.001); and for group III, AV Vmax and AVPGmean decreased significantly (P<0.001), EROA, Rvol and AR width decreased significantly (P<0.001), IVST decreased (P<0.05), PWT decreased (P < 0.05), LVEDD significantly decreased (P<0.001), and LVEF increased (P<0.05). During the follow-up, 5 patients died, and 13 patients were implanted with permanent pacemakers. Conclusion Echocardiography plays an important role in the preoperative assessment, intraoperative monitoring and postoperative follow-up of patients with different types of AVD receiving TAVR and can provide a basis for the evaluation of efficacy and prognosis of TAVR.