Evaluation for TAVR
Initially, TAVR was intended for patients who were at too high a risk to undergo open-heart surgery. 现在，它被批准用于任何有严重主动脉狭窄的人. 来决定它是否适合你, our team of heart specialists will evaluate your heart health as well as your overall health. You may have all or some of the following tests as part of the evaluation:
- Blood tests. 这些检查可以帮助十大赌博平台排行榜评估你的健康状况. 它们可能包括红细胞计数, which indicates how much oxygen is being delivered to your body's cells; electrolyte levels, which can be disturbed by an underlying illness; and tests to measure substances in the bloodstream that reflect how well your kidneys, liver and thyroid are working.
- Chest X-ray. This exam can show the size of your heart and reveal whether you have fluid buildup in your lungs.
- Electrocardiogram (EKG). 这是一种评估心脏电活动的无痛测试. Electrodes are taped to your chest, arms and legs to record and measure the signals that cause your heart to beat.
- 经食管超声心动图TEE. During a TEE, an ultrasound probe is inserted into your esophagus to capture clear images of your heart's chambers and valves. 这些图像用于评估血液如何流经心脏.
- Cardiac MRI or CT scan. 这些检查提供血管的详细图像, the blood flow through your heart, 心脏的结构和运动.
- Right heart catheterization. This exam may be performed to collect more information about how well your heart is pumping. A catheter is inserted through a blood vessel and threaded into the heart, where it measures the blood pressure in your heart and in the main arteries of your lungs. 导管还可以测量心输出量和血氧水平.
如果你的十大赌博平台排行榜怀疑你有 coronary artery disease (CAD)除了主动脉狭窄，你还可以做以下检查:
- Coronary angiogram. 这提供了心脏血管的图像来检测阻塞. During this test, a catheter is inserted into a blood vessel (usually in the groin area) and threaded up to the heart. A contrast dye (a harmless substance that shows up well on X-rays) is injected through the catheter, x光图像追踪流向心脏肌肉的血液.
- Exercise stress test. 这显示了你的心脏对用力的反应. You'll either be given medication that makes your heart work extra hard, 或者要求锻炼(在跑步机或固定自行车上), 同时我们会追踪你的生命体征并监测你的心脏反应.
如果您的测试表明您将受益于TAVR, 我们的心脏护理团队将为您制定治疗方案. 每个病人的团队都包括一名心脏病专家, cardiac surgeon, interventional cardiologist, 执业护士和影像专家.
Preparing for a TAVR
我们的团队会安排你和加州大学旧金山分校见面 Prepare Program. The program staff are dedicated to preparing you for your scheduled procedure, 包括确保你完成所有必需的测试. They will review your medications to be certain you have the correct instructions regarding their use and will discuss your pain control options. They will share all their communication and information with the TAVR team.
如何准备TAVR手术?
- 和你的十大赌博平台排行榜谈谈你的药物. Find out which ones you should or shouldn't take on the days leading up to your procedure, on the day itself, and on the following days.
- Get a dental checkup. 口腔细菌可以感染心脏瓣膜.
- Make a recovery plan. It's important to work out details, such as who will take you home, stay with you at home, 做一些事情，比如帮你准备饭菜.
TAVR Procedure
We perform TAVR procedures in a state-of-the-art operating room at the UCSF Helen Diller Medical Center at Parnassus Heights. 手术前，你会有一个 echocardiogram然后我们将带您到手术室.
Our team will have already determined the type of anesthesia they'll use for you, 因为最佳选择取决于一定的健康因素. 在你完全睡着的时候可以给你做全身麻醉, 或者服用镇静剂，让你保持清醒，但放松，感觉不到疼痛.
Once you are under anesthesia, the doctor will make a small incision in either your groin or chest and insert a catheter into the major artery there. 十大赌博平台排行榜会用这个给你的心脏输送一个新的瓣膜. The new valve is collapsed so it can pass easily through the catheter to your heart.
作为程序的一部分，我们将放置一个临时的 pacemaker 确保你的心跳保持正常. In many patients, we also place a filtration device inside a blood vessel in your neck. This device lowers the risk of stroke by capturing any tiny bits of plaque that come loose during the procedure, 阻止它们到达大脑. 该装置通过手腕上的一个小切口插入.
Once the replacement valve is inside your damaged valve, the new valve is expanded to full size. It then pushes aside the "leaflets" of the old valve – the flaps that open and close – and takes over the job of regulating blood flow from the heart. The new valve is typically made of bovine (cow) or porcine (pig) tissue; both are compatible with human tissue.
放置瓣膜后，我们取出临时起搏器. If we detect a slow heart rate, however, we may wait until the following day to remove it. 你脖子上的过滤装置也被移除. The whole operation takes about two to three hours – half as long as open-heart surgery.
Another echocardiogram is performed immediately after the procedure to assess how the new valve is functioning. 一旦完成，你就会被带到恢复区.
Recovery from TAVR
Immediately after the procedure, you'll recover in the post-anesthesia care unit. 然后你会被转移到我们的过渡护理中心或者 intensive care unit，这取决于你需要的护理水平.
患者被鼓励在24小时内起身走动. Most patients spend one to two nights in the hospital, where they are closely monitored. During your hospital stay, 你的心脏护理团队会进行几次后续检查, including a chest X-ray, EKG and echocardiogram, 确保你的心脏功能正常.
Before you go home, your team will talk with you about caring for yourself. They’ll cover topics such as diet, exercise, care of your incision sites, and any new medications.
After discharge, 你需要和你的初级保健十大赌博平台排行榜定期检查, 当地的心脏病专家和心脏小组, as necessary. These checkups are important to ensure all is well with your new valve and to detect any potential problems early.
特别是在家里恢复的头几周, 你需要注意自己的感受. 如果你有不寻常的头痛, 头晕或其他相关症状, 立即打电话给给你做手术的十大赌博平台排行榜或拨打911.
We advise patients not to drive for at least 72 hours after the procedure (to allow the incisions to heal) and to avoid strenuous physical activity for 10 days. TAVR的恢复比开胸手术的恢复要快得多, 大多数患者可以在两周内恢复正常活动. 然而，完全恢复可能需要一到两个月的时间.
You can talk to one of our social workers about the help and care you may need at home as you heal. 有些病人可能需要家庭护理护士或护士 cardiac rehabilitation program after a TAVR.
This program includes a team of health care professionals who provide an individualized exercise plan, education and support to help you improve your heart health and quality of life. 询问你的十大赌博平台排行榜心脏康复是否适合你.
