To investigate the operative cooperation of transcardial aortic valve replacement (TAVR) with domestic J-Valve? stent in the treatment of high-risk simple non calcified aortic regurgitation.

From March 2017 to March 2018, 15 patients with simple high-risk non calcified aortic regurgitation in Beijing Anzhen Hospital, Capital Medical University were collected. All patients were performed transapical TAVR using domestic J-Valvetm? system. After careful preoperative evaluation [including preoperative visit, familiarity with instruments and equipment, interventional consumables and equipment, etc.], smooth operation cooperation (including strict adherence to aseptic principle, intraoperative patients temperature protection, X-ray protection, activated clotting time of whole blood (ACT) monitoring and stent valve assembly, etc.] and intraoperative safety management (including the nursing of preventing the displacement of the conveyor and catheterization of artery, etc.). Whether the patient successfully disengaging from the ventilator in ICU, and extubate the tracheal intubation blood volume, ICU time and ventilator-assisted ventilation time, ejection fraction and whether there is perivalvular leakage; to understand the cardiac function classification, activity tolerance, chest tightness, angina pectoris and other symptoms.Whether the tracheal intubation successfully removed from the ventilator in ICU was observed. The average intraoperative blood loss, the patients′ time in ICU and ventilator assisted ventilation, the ejection fraction were observed. Whether the perivalvular leakage being presented was observed. The cardiac function classification, activity tolerance, chest tightness, angina pectoris and other symptoms were observed.

All patients successfully completed transapical TAVR, without cardiopulmonary bypass, ventricular rapid pacing, and conventional cardiopulmonary bypass. No coronary artery occlusion or valve displacement occurred. No valvular stenosis and perivalvular leakage were found. The mean intra-aortic pressure difference immediately after operation was [5.8 (4.9, 12.9)]mmHg (1 mmHg = 0.133 kPa). The mean blood loss was [200.0 (100.0, 500.0)] mL, the duration of ICU stay was (1.2 ± 0.4) d, the duration of ventilator assisted ventilation was [19.0 (8.5, 23.5)] h, and the mean ejection fraction was (56.2±15.6) %. Only 2 patients had micro perivalvular leakage. In the last follow-up, 10 patients had grade I cardiac function, 4 patients were grade Ⅱ, and 1 patient was grade Ⅲ; the activity tolerance of patients was significantly improved compared with that before operation; the symptoms of chest tightness and angina pectoris were significantly improved after operation.

The operating room nurses should correctly grasp the operation cooperation method of TAVR, do a good job in psychological nursing and preoperative preparation of patients, and cooperate closely with surgeons during the operation, which is the guarantee of successful operation.