Transesophageal echocardiography during endovascular aortic valve replacement (TAVI)

Abstract

Objective: to evaluate the effectiveness of endovascular aortic valve replacement (TAVI) according to transesophageal echocardiography. Materials and methods: 29 TAVI operations were performed in patients with aortic valve stenosis (AV) with Lotus Valve system (Boston Scientific, USA) and CoreValve (Medtronic, USA). All patients underwent intraoperative Chpehokg on devices sh50 (Philips, the Netherlands), ACUSON SC2000 (Siemens, Germany) transesophageal sensors X7-2t, Z6Ms, at the following stages of operation: 1 - after intubation of the patient; 2 - the main stage of operation: when placing the conductor in the cavity of the left ventricle, after balloon valvuloplasty, when positioning and implantation of the prosthesis; 3 - the end of the operation. TEE at the beginning and end of the operation was conducted according to the accepted Protocol. Results: all patients had pronounced AV stenosis, peak and average pressure gradients on AV were 90.0±27.0 and 51.5±16.5 mm Hg. respectively. Intraoperative TEE in 3D mode and creating a model of the aortic root, the calculated linear dimensions of the aortic root, which coincided with the data of CT. One patient was diagnosed with worsening of the degree of mitral stenosis to expressed in the formulation of the CoreValve system, and also recorded one episode of severe pericardial effusion after placing the conductor in the cavity of the left ventricle. In all patients, hemodynamic parameters and function of prostheses after surgery were within normal limits, with an average pressure gradient on the AK prosthesis was 5.9±2.8 mm Hg. Conclusion: Tee is a basic method in the assessment of valvular structures of the heart, is of great importance for the timely diagnosis of complications during surgery endovascular aortic valve replacement, and research in 3D and 4D modes can replace the expensive research.