An elderly woman surnamed Chiang who is 92 years old underwent an open-heart surgery for aortic stenosis 10 years ago. Since the useful life of an implanted valve is limited to about 10 years, she needed to have a new valve implanted. If done by conventional surgery, the mortality rate for a second operation of this sort would be 10 to 20 percent. However, the Cheng Hsin Hospital used transcatheter aortic valve implantation (TAVI), in which there is no need to “open the heart.” Instead, a catheter is used to implant the valve via the femoral artery.
Yin Wei-hsian, chief of Cheng Hsin Hospital’s Division of Cardiology, says that aortic stenosis usually occurs in elderly people aged 65 or older. As people get older, the aortic valve may become hardened, calcified or narrowed, causing decreased blood flow, which may in turn lead to symptoms such as heart failure, angina and fainting.
Wei Jeng, chief of Cheng Hsin Hospital’s Heart Center, points out that the conventional approach to aortic stenosis requires implanting a valve by means of open-heart surgery, but if the patient is over 80 years old and has undergone an implantation in the past, most doctors will generally refuse to operate on them because the surgery is too risky.
Photo: Lin Hui-chin, Liberty Times
照片：自由時報記者林惠琴
Yin says that TAVI requires a smaller incision and a much shorter surgical procedure, and the patient can get out of bed on the same day, while the operation carries a risk of less than 3 percent. The only problem is that the National Health Insurance scheme currently does not pay for this procedure, so patients have to pay around NT$1 million out of their own pockets to have it done.
Since performing its first TAVI in 2013, Cheng Hsin Hospital has carried out this procedure on more than 150 patients whose average age is 83, and the oldest of whom was 101 years old.(Liberty Times, translated by Julian Clegg)
高齡九十二歲的江奶奶，十年前因心臟主瓣膜狹窄曾動過一次「開心」手術，由於置放瓣膜的使用期限大約十年左右，因此須置放新瓣膜。若採用傳統手術，第二次手術死亡率高達百分之十至二十，但振興醫院使用「經導管人工主動脈瓣膜植入術」（TAVI），不用「開心」，只要利用導管經由股動脈穿刺置放瓣膜即可。
振興醫院心臟血管內科主任殷偉賢表示，主動脈瓣膜狹窄通常發生在六十五歲以上的老年人口。隨著年齡增長，主動脈瓣膜發生硬化、鈣化、狹窄等問題，造成血流不流暢，進而有心衰竭、心絞痛、暈厥等症狀。
振興醫院心臟醫學中心主任魏崢指出，針對主動脈瓣膜狹窄，傳統須「開心」置放瓣膜，但若是八十歲以上的患者，且曾經接受置放手術，因為手術風險過高，通常醫師會拒絕為其動刀。
殷偉賢說，TAVI的傷口小，大幅縮短術程，當天就可下床。手術風險在百分之三以內。只是目前健保尚未給付，患者必須自費上百萬元。
從二○一三年進行首例TAVI以來，振興醫院已將此術應用於一百五十位以上的患者，平均年齡八十三歲，其中年齡最高者為一百○一歲。(自由時報記者林惠琴)
A: Yet another shopping mall has just opened in Taipei. B: Do you mean the Mitsui Shopping Park LaLaport Nangang? A: Yeah, the shopping mall run by Japanese Mitsui & Co. opened last week. B: I hear the mall features about 300 stores, Vieshow Cinemas and Japanese Lopia supermarket. A: With the opening, a war is breaking out between Taipei’s department stores. A: 台北又有新的購物商場可逛啦。 B: 你是說Mitsui Shopping Park LaLaport 南港？ A: 對啊這家日本三井集團旗下的商場上週開幕。 B: 聽說商場有威秀影城、樂比亞日系超市，還有多達300家專櫃。 A: 新商場一開幕，看來又要掀起一場百貨大戰啦！ （By Eddy Chang, Taipei Times／台北時報張迪）
A: Hey, didn’t you go to the opening of the Mitsui Shopping Park LaLaport Nangang last week? B: Yeah, there are about 300 shops, including the first overseas branch of Japan’s Mahou Dokoro — a famous Harry Potter-themed store. A: Wow, I’ve always wanted to get a magic wand. B: There are also a bunch of great restaurants, such as Smart Fish hotpot restaurant. A: I wish I had Harry Potter’s “apparition” and “disapparition” magic, so I could teleport to the mall right now. A: 你上週不是有去LaLaport南港的盛大開幕嗎？有什麼特別的？ B: 那裡有多達300家專櫃，包括魔法之地的海外首店——它可是日本知名的《哈利波特》專賣店。 A: 哇我一直想買根魔杖。 B: 另外還有各式各樣的美食，像是林聰明沙鍋魚頭。 A: 真希望我也有哈利波特的「現影術／消影術」魔法，能瞬間移動到商場去！ （By Eddy Chang, Taipei Times／台北時報張迪）
When it comes to movies, some people delight in watching spine-chilling horror films. Surprisingly, apart from containing a few scares, horror movies may also offer an unexpected __1__. According to a study, watching 90 minutes of a scary movie can burn an average of 113 calories, which is roughly __2__ to taking a 30-minute walk. Researchers from the University of Westminster carried out an experiment in which they __3__ participants’ oxygen intake, carbon dioxide output, and heart rates while they were watching horror movies without any distractions. The results revealed that physiological responses to fear play a crucial role
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