Objective: To analysis the application value of image fusion technology in transcatheter aortic valve implantation (TAVI). Methods: A total of 35 patients underwent trans-femoral TAVI using the first-generation VENUS-A valve in Heart Center of Henan Provincial People's Hospital from January 2020 to May 2021 were analyzed retrospectively. Among them, there were 21 males and 14 females, aged from 64 to 81 years, with a mean (SD) of (71.37±5.66) years. They were divided into conventional group (n=22) and fusion group (n=13), according to whether image fusion technology was used during operation. The preoperative general data, intraoperative data, differences of postoperative renal function and residence time in intensive care unit (ICU) were analyzed and compared between the two groups. The postoperative echocardiography and 12 lead ECG were observed. Results: All 35 patients in this study were with severe aortic stenosis, of which, 10 patients were complicated with moderate to severe regurgitation. Compared with the conventional group, the intraoperative fusion group had fewer angiography times [3.0 (3.0, 4.0) vs 5.0 (5.0, 6.0)], X-ray absorbed dose [342.0 (44.5) mGy vs 388.4 (71.0) mGy], and contrast dosage [(73.5±10.5) ml vs (90.3±10.3) ml], and shorter rapid pacing time [(14.0±1.6) seconds vs (16.5±2.0) seconds] (all P<0.05). There was no significant differences in X-ray irradiation time, operation time, sizing of the pre-dilated balloon, valve implantation depth and other indicators (all P>0.05). There was no significant differences in ICU retention time and postoperative renal function (all P>0.05). Postoperative echocardiography showed that the function of aortic valve was good, with mild perivalvular leakage in 2 cases in the conventional group and 1 case in the fusion group; and one patient was implanted with permanent pacemaker after TAVI in the conventional group. Conclusion: Image fusion technology simplifies the TAVI process, shortens the ventricular pacing time and reduces the dosage of X-ray and contrast, and has certain clinical application value.
目的： 分析影像融合技术在经导管主动脉瓣植入（TAVI）中的应用效果。 方法： 回顾性分析2020年1月至2021年5月期间河南省人民医院心脏中心应用第Ⅰ代VENUS-A瓣膜经股动脉途径行TAVI治疗的35例患者临床资料，其中男21例，女14例，年龄64~81（71.37±5.66）岁。根据术中是否采用影像融合技术分为常规组（22例）和融合组（13例）。分析对比两组患者术前一般资料、术中资料（X线吸收剂量、对比剂使用量、造影次数以及快速起搏时间等）以及术后肾功能、重症监护病房滞留时间的差异，观察术后超声心动图及12导联心电图情况。 结果： 35例患者均为主动脉瓣重度狭窄，其中有10例合并中重度关闭不全。与常规组相比，术中融合组的造影次数［M（Q1，Q3）］［3.0（3.0，4.0）比5.0（5.0，6.0）次］、X线吸收剂量［342.0（44.5）比388.4（71.0）mGy］、对比剂使用量［（73.5±10.5）比（90.3±10.3）ml］少，快速起搏时间［（14.0±1.6）比（16.5±2.0）s］短（均P<0.05）；两组X线照射时间、手术用时、预扩球囊大小、瓣膜植入深度等指标的差异均无统计学意义（均P>0.05）。两组术后重症监护病房滞留时间及肾功能差异无统计学意义（均P>0.05）。术后超声提示主动脉瓣功能良好，常规组2例、融合组1例出现少量瓣周漏；常规组植入永久起搏器1例。 结论： 影像融合技术简化了TAVI手术流程，缩短了心室起搏时间，减少了X线吸收剂量和对比剂的使用量，具有一定的临床应用价值。.