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三軍總醫院心臟外科主治醫師柯宏彥今日表示，在我國邁入老年化社會之際，主動脈瓣膜狹窄的心臟疾病為老年長照的主要課題，針對不適合傳統開心手術的年長或合併多重疾病的患者，經導管主動脈瓣膜置換（Transcatheter Aortic Valve Replacement，簡稱TAVR）可提供有效治療及良好預後，使病人早日恢復健康並提升生活品質。

柯宏彥以82歲的陳姓病患為例，今年初經心臟超音波檢查出嚴重主動脈瓣膜狹窄導致心臟衰竭及腦部循環不足等症狀，在與病患及家屬討論，考量傳統開心手術的風險較高，最後決定接受微創的經導管主動脈瓣置換手術（TAVR）治療。手術順利成功，僅有鼠蹊部不到一公分的傷口。

柯宏彥表示，主動脈瓣膜是心臟幫浦的門戶，一旦因為退化或風濕等原因造成瓣膜出口狹窄，除導致心臟無法輸出足夠的血液供應全身器官的循環，也會造成心臟費力做工而導致心臟本身衰竭，病患初期可能有心絞痛、頭暈、甚至暈厥等症狀，後期更會進展到心臟衰竭而有喘及水腫的情形，若不加以介入處理，則平均存活時間不超過兩年，而最有效的治療方式就是瓣膜置換手術。

柯宏彥指出，傳統開胸主動脈瓣置換手術是相當成熟且有效的手術，但對年紀大又併發有許多慢性病的銀髮族長者，手術及麻醉的風險相對提高，近年拜科技進步所賜，三總已發展出經由周邊導管方式植入壓縮的組織瓣膜進行主動脈瓣膜置換技術，可避免傳統開胸手術的大傷口、體外循環心臟暫停以及長時間的全身麻醉，所以病患術後可恢復較快，重返正常生活，不再為心臟衰竭所苦進而提升生活品質。

柯宏彥進一步表示，三軍總醫院於去年建構完成新一代混成手術室（Hybrid OR），裝設亞洲第一台最新一代的高解析度多軸式機械手臂攝影系統，並引進國外原廠最新一代之經導管植入式瓣膜，該院心臟介入團隊在院長蔡建松領導下，利用最先進的微創技術及設備，提供銀髮族病患或不適合傳統開胸進行主動脈瓣膜置換患者最精準有效的治療，以期造福病患並提升生活品質！

laennecKe Hongyan, attending physician of Department of Cardiac Surgery, General Hospital of the Three Armies General said today that as China enters an aging society, heart disease of aortic valve stenosis is the main subject of elderly long-term care for elderly patients with multiple or multiple diseases that are not suitable for traditional open surgery. Transcatheter Aortic Valve Replacement (TAVR) can provide effective treatment and good prognosis, so that patients can return to health and improve their quality of life as soon as possible.

Ke Hongyan, an 82-year-old patient with a surname of Chen, was diagnosed with severe aortic valve stenosis leading to heart failure and insufficient brain circulation at the beginning of this year. He discussed with patients and their families and considered the risk of traditional open surgery. Higher, and finally decided to receive minimally invasive transcatheter aortic valve replacement surgery (TAVR). The operation was successful, with only a one-centh wound in the groin.

Ke Hongyan said that the aortic valve is the portal of the heart pump. Once the valve outlet is narrowed due to degeneration or rheumatism, the heart can not output enough blood to supply the circulation of the whole body organs, which will cause the heart to work hard and cause the heart itself to fail. In the early stage of the disease, there may be symptoms such as angina pectoris, dizziness, and even syncope. Later, it will progress to heart failure and have asthma and edema. If not treated, the average survival time is no more than two years, and the most effective treatment. The way is valve replacement surgery.

Ke Hongyan pointed out that traditional open thoracic aortic valve replacement surgery is a fairly mature and effective operation, but for the elderly who are older and have many chronic diseases, the risk of surgery and anesthesia is relatively high. In recent years, thanks to scientific and technological progress, Aortic valve replacement technology has been developed by implanting a compressed tissue valve through a peripheral catheter to avoid large wounds of traditional thoracotomy, cardiac cycle of cardiopulmonary bypass, and long-term general anesthesia, so patients can recover faster after surgery. Returning to normal life, no longer suffering from heart failure and thus improving the quality of life.

Ke Hongyan further stated that the General Hospital of the Three Armies built a new hybrid operating room (Hybrid OR) last year, installed the first generation of high-resolution multi-axis robotic arm photography system in Asia, and introduced the latest generation of foreign original factories. Through the catheter-injected valve, the hospital's cardiac intervention team, under the leadership of Dean Cai Jiansong, uses the most advanced minimally invasive techniques and equipment to provide the most accurate and effective treatment for patients with silver-haired patients or those who are not suitable for traditional thoracotomy for aortic valve replacement. In order to benefit patients and improve their quality of life!

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