A case report：Ultrasound-guided “one-stop” transcatheter aortic valve replacement + interventional closure of atrial septal defect

Purpose: ：Transcatheter aortic valve replacement (TAVR) is a suitable option for elderly patients who are unable to undergo traditional thoracotomy. In this case, the patient was frail and had multiple underlying diseases, in addition to suffering from atrial septal defect and moderate to severe aortic stenosis and regurgitation, resulting in abnormalities in cardiac function and morphology. To address these issues, a combination of imaging methods such as three-dimensional ultrasound was used to guide the patient to undergo a one-stop transcatheter aortic valve replacement and interventional closure of atrial septal defect during the operation. This one-stop surgery required a highly professional team of doctors and advanced medical equipment. Methods: ：Prior to the surgery, a thorough assessment of the patient’s cardiac function was conducted using transthoracic echocardiography and transesophageal echocardiography. The degree of stenosis above and below the valve was also measured. During the procedure, real-time monitoring of the release of the self-expanding flap was done using TEE to guide the surgeon in adjusting the surgical strategy as needed. Postoperatively, transthoracic echocardiography is utilized to monitor the patient’s prognosis with accuracy. Results: ：Ultrasound assessment is a crucial tool in the perioperative period, serving as an essential screening method for surgical patients. Furthermore, it is instrumental in quantifying the degree of aortic valve stenosis, selecting valve size, and determining the optimal location for the surgical approach. By utilizing ultrasound-guided one-stop transcatheter aortic valve replacement and interventional closure of atrial septal defect, we were able to effectively address the patient’s heart condition and enhance their overall quality of life. Conclusion: ：This surgical technique involves replacing traditional surgery with a minimally invasive approach, which eliminates the need for a second open heart surgery and reduces trauma to the body. Furthermore, it considerably reduces the operation and postoperative recovery time. By utilizing minimally invasive techniques, patients can achieve significant surgical results in a shorter period and with a faster recovery time.