December 17th, Renji Hospital successfully performed its first case of transcatheteraorticvalve implementation (TAVI).It marked that theinterventional diagnosis and treatment level of ourcardiovascular surgery stepped onto a new stage.

The patient was a 63-year-old male who had a history of livertransplantation. He was admitted for "repeated chest tightness andsyncopetwice". The echocardiographyshowed"severe aortic stenosis." Considering that the patient was in high risk with STS score greater than12 for the history of liver transplantation, long-term oralimmuno suppressant, coronary heart disease, COPD and peripheral vascular disease, the risk of traditional thoracotomy was too high. After repeated discussions within thedepartment, the doctors determined that the patient had indication of TAVI.But since that the patient had peripheral vascular disease and his bilateral femoral arteries, carotid and subclavianarteries were not suitable for peripheralprocedure for serious lesions, the operation team finally chose the ascending aortasurgicalapproach through a small incision in the sternumabout 3cmupper section to save his life.

TAVI  has a high requirement of surgeons’ operating skills. Thanks to the accumulation of experiencein recent years, the interventional team had mastered this novel technique on the basis of their skilled traditional surgical procedures, which laid a solid foundation of current success. Multidisciplinary treatment (MDT) mode also exhibited its advantages. Ben He (Director of Cardiology),SongDing and Hang Zhao (cardiology physician), Jie Chen (Director of anesthesiology), Jie Zhang (anesthesiology physician), JiWang and YingWu(radiology physician) and personnel of the operating room gave close cooperationand support. The operation lasted more than two hours and finally succeeded. The patient got extubation on the day of operation and recovered well.

TAVI  is a new technology carried out at home and abroad. Because it avoids the risk of traditional thoracotomy and cardiopulmonary by passsurgery, it is especially suitable for high-risk elderly  patients who cannot tolerate the traditional procedure. TAVI has been carried out more than20million cases abroad, but it started late at home and only a few large hospitals have carried out few clinical researches. Two years ago,SongXue, director of cardiovascular surgery set up a special technical research team of TAVI. The interventional subspecialty group mainly consisted of Surgeon Jidong Liu, XinmingDi and WengangYang, together with department of cardiology, echocardiography and anesthesiology, went to large foreign heart centers to learn the technique of TAVI. In the future, the team will provide better choices and more possibilities for more patients with severe cardiovascular diseases.

Correspondent Ritai Huang ; Translator Yujun Sun