TAVR is a minimally invasive cath-based procedure to replace the aortic valve in a patient with severe aortic stenosis.

主動脈瓣置換術（TAVR）是一種微創陰式手術，用於為主動脈瓣嚴重狹窄的患者置換主動脈瓣。

It's for individuals that are high risk or too sick for open heart surgery.

它適用於高風險或病情過於嚴重而無法進行開胸手術的患者。

Left untreated, aortic valve stenosis can lead to more serious heart problems.

如果不及時治療，主動脈瓣狹窄會導致更嚴重的心臟問題。

Dr. George Hodge from UnityPoint Health Cardiology Clinic explains the procedure and who is a candidate for TAVR.

UnityPoint Health心臟病診所的喬治-霍奇（George Hodge）醫生解釋了該手術以及哪些人適合進行 TAVR。

The aortic valve is one of the heart valves.

主動脈瓣是心臟瓣膜之一。

There are four valves in the heart.

心臟有四個瓣膜。

The aortic valve is the valve that sits between the left bottom chamber of the heart, we call it left ventricle, which is the main chamber of the heart that pumps the blood to the whole body, and between the aorta, which is the blood vessel, the largest blood vessel that we have, that comes out of this left ventricle and distributes the blood to the whole body.

主動脈瓣是位於心臟左下腔（我們稱之為左心室）和主動脈之間的瓣膜，左心室是心臟的主要腔室，負責將血液泵送到全身，而主動脈則是從左心室出來並將血液輸送到全身的血管，也是我們擁有的最大的血管。

And this valve opens and closes.

這個閥門可以打開和關閉。

It opens when the heart is squeezing, when this left ventricle is contracting to let the blood flow to the whole body, and closes when this left ventricle is relaxing and filling with blood in order to prevent the blood that was just ejected by this ventricle from leaking backwards into it.

當心髒受到擠壓，左心室收縮以讓血液流向全身時，它就會打開；當左心室放鬆並充滿血液時，它就會關閉，以防止剛剛被心室射出的血液向後滲入心室。

And aortic stenosis, aortic, refers to the aortic valve, stenosis refers to, refers to inability of this valve to open very well.

主動脈瓣狹窄指的是主動脈瓣，狹窄指的是主動脈瓣不能很好地打開。

And the ventricle, although may be working normally, the valve not being able to open will decrease blood flow basically to the whole body.

而心室雖然可以正常工作，但瓣膜無法打開基本上會減少流向全身的血液。

That usually translates into symptoms with exertion, shortness of breath with exertion, chest discomfort with exertion, dizziness with exertion, because the brain is not getting enough blood flow, the heart is not getting enough blood flow, and blood is being backed up and filling the lungs, which could cause the shortness of breath with exertion.

這通常會轉化為用力時的症狀、用力時氣短、用力時胸部不適、用力時頭暈，因為大腦得不到足夠的血流，心臟得不到足夠的血流，血液倒流並充滿肺部，這可能會導致用力時氣短。

So when we have severe degree of this aortic valve stenosis, and we have symptoms, it is highly recommended to fix this valve.

是以，當主動脈瓣狹窄程度嚴重並出現症狀時，我們強烈建議對瓣膜進行修復。

There are no medications currently that will slow the progression of this disease or cure it.

目前還沒有任何藥物可以減緩或治癒這種疾病。

The only treatment is a procedure.

唯一的治療方法就是手術。

There are two ways we can do this.

我們有兩種方法可以做到這一點。

Classically, we replace the aortic valve surgically.

通常，我們會通過手術更換主動脈瓣。

The surgeon cuts the chest open, stops the heart, uses an artificial heart for a certain amount of time, enough for him or her to remove the defective valve and place a prosthetic valve in place.

外科醫生會切開胸腔，讓心臟停止跳動，在一定時間內使用人工心臟，以便取出有缺陷的瓣膜，並將人工瓣膜安裝到位。

Then the heart is restarted, artificial heart is stopped, chest is closed.

然後重新啟動心臟，停止人工心臟，關閉胸腔。

And this is typically what we call AVR, aortic valve replacement.

這就是我們通常所說的 AVR，主動脈瓣置換術。

Now, over the last few years, there has been a lot of advances in how we do this treatment.

在過去的幾年裡，我們的治療方法有了很大的進步。

And we added a T before the AVR and it becomes TAVR, so transcatheter aortic valve replacement.

我們在 AVR 前加了一個 T，就變成了 TAVR，即經導管主動脈瓣置換術。

And that refers to replacing the heart valve without cutting the chest open by making an incision in the groin and accessing the artery that's in the groin, and from there going back to the heart and placing a valve inside the patient's previous valve.

這是指在不切開胸腔的情況下，通過在腹股溝切開切口，進入腹股溝的動脈，然後回到心臟，將瓣膜置入患者之前的瓣膜內，從而更換心臟瓣膜。

We use the defective valve to anchor the new valve in place.

我們使用有缺陷的閥門將新閥門固定到位。

This old defective valve gets crushed against the wall of the aorta, which is that blood vessel that comes out of the left ventricle, and this new valve starts functioning immediately.

這個有缺陷的舊瓣膜被壓在主動脈壁上，主動脈是從左心室出來的血管，而這個新瓣膜會立即開始工作。

Our patient undergoing TAVR is Donald Waterman, an 88-year-old from eastern Iowa.

接受 TAVR 的患者是來自愛荷華州東部的 88 歲老人唐納德-沃特曼（Donald Waterman）。

He was experiencing a rapid and irregular heart rate and went to St.

他出現了心率過快和心率不齊的症狀，於是前往 St.

Luke's ER.

盧克急診室

Up to that point in time, Waterman had been closely monitored by a UnityPoint Health cardiologist.

在此之前，沃特曼一直接受 UnityPoint Health 心臟病專家的密切監測。

With this change in condition, it was determined he would undergo the TAVR procedure.

隨著病情的變化，他被決定接受 TAVR 手術。

I would say about at least a third of the patients have been able to go home the next morning after having their heart valve replaced the day before.

我想說，至少有三分之一的病人在前一天更換了心臟瓣膜後，第二天早上就可以回家了。

And the team has grown and we now are implanting all the valves that are on the market, all the different valves.

隨著團隊的壯大，我們現在可以植入市場上所有的瓣膜，所有不同的瓣膜。

And of course, each valve has certain features and certain patients may benefit more from one or the other.

當然，每種瓣膜都有一定的特點，某些病人可能從其中一種瓣膜中獲益更多。

Most patients will do very well with either one of the valves.

大多數患者使用其中一種瓣膜都會很好。

Family reports Waterman is feeling less tired after his procedure and feel he was in the right place at the right time.

家人報告說，沃特曼在手術後感覺沒那麼累了，他覺得自己在正確的時間出現在了正確的地點。

They indicate his quality of life is better and feel fortunate to have this option in Cedar Rapids, allowing them to stay close to home and avoid travel.

他們表示，他的生活品質得到了改善，併為在錫茲拉皮茲有這樣的選擇感到幸運，這讓他們可以離家近一些，避免了旅行。

Patient satisfaction has been great.

病人的滿意度一直很高。

And again, I want to remind patients that this treatment, currently at least, is mainly for patients who are at intermediate or high risk of having complications or dying from an open, classical, open heart surgery with valve replacement with a surgeon alone.

我想再次提醒患者，至少目前這種治療方法主要是針對那些有中度或高度併發症風險的患者，或者那些僅靠外科醫生進行經典的開放式心臟手術瓣膜置換而死亡的患者。

For the patients who are at a low risk, we don't know yet if they'll do well or not.

對於低風險的病人，我們還不知道他們是否會康復。

Currently, this is being studied in the research trials.

目前，研究試驗正在對此進行研究。

So for patients who are elderly, who are frail, and again, we calculate a score that tells us what is the chance that this patient is going to have a major complication from a classical open heart surgery.

是以，對於年老體弱的病人，我們會計算出一個分數，告訴我們這個病人在傳統的開胸手術中出現重大併發症的機率有多大。

And if it says that it's intermediate or if it's high, then we tend to do TAVR.

如果顯示為中度或高度，我們傾向於進行 TAVR。

And mainly because it has been proven that TAVR is either equal or superior in these patients, especially in the patients that are high risk is actually superior to surgery and the intermediate risk is similar to surgery.

這主要是因為事實證明，TAVR 對這些患者的治療效果要麼相同要麼更好，尤其是對高風險患者而言，TAVR 的治療效果實際上優於手術，而中度風險患者的治療效果則與手術相似。

With the advantage of quicker recovery, less pain and discomfort going home sooner as opposed to classical open heart surgery.

與傳統的開胸手術相比，它的優勢在於恢復更快、疼痛和不適感更少、更早回家。

UnityPoint Health Cedar Rapids Heart and Vascular Institute offers advanced technologies and procedures to help patients stay close to home.

UnityPoint Health 西達拉皮茲心臟和血管研究所提供先進的技術和程序，幫助患者就近就醫。

We invite you to learn more about UnityPoint Health Heart Care Services and how to prevent heart disease.

我們誠邀您進一步瞭解 UnityPoint Health 心臟護理服務以及如何預防心臟病。