Edwards主动脉瓣支架10.ppt

Edwards支架;;;Incidence of valvular heart disease;Grading the degree of aortic stenosis;Natural history of AS;Causes;Management strategy for patients with severe AS;Three-year outcome after balloon aortic valvuloplasty in adult with severe AS;Survival among patients with severe symptomatic AS who underwent AVR and No surgery;Surgical Treatment of AVS ;Core Valve自膨胀;;;;;;Edwards支架近期临床研究---SOURCE研究;;;;;;PARTNER 研究;;PARTNER cohort B ----TAVI vs Standard Therapy;;;;;;PARTNER cohort A ----TAVI vs Surgical AVR;;;;;;;;;;Edwards支架瓣中瓣技术;一、Transcatheter Valve-in-Valve for Failed Bioprosthetic Heart Valves ;二、Transcatheter Valive-in-Valve for Edwards Aortic Valves Malposition;三、Transcatheter Valve-in-Valve for Bioprosthetic Aotic and Mitral Valve;;TAVI适应证;;TAVI术Edwards支架禁忌症;图1 股动脉直径只有5.2mm； 图2 风湿性主动脉狭窄； 图3 极度扭曲的髂动脉； 图4 窦底距左主干仅10mm；;欧洲心脏手术风险评分系统(EuroSCORE);TAVI术流程（Edwards支架）;;1、适应症病人选择;2、术前病人评估;3、术中操作及团队配合;3、术后恢复;3、出院及随访;;导管室;;Edwards成套设备(经股动脉);;;穿刺右侧股动脉后造影确认鞘管在股动脉主支中;;;;;;;支架预载鞘;;;;A 支架进入瓣环;TAVI Procedure Steps of Edwards;Edwards支架术注意事项;一、TAVI时主动脉瓣造影体位;二、支架和输送鞘型号的选择;三、TAVI术中临时起搏器的使用;三、支架装载方向的确认;四、术中一些意外的处理;五、关于股动脉伤口的处理;六、关于TAVI手术路径的选择;七、关于导管室和手术团队配备;1、