Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Can J Cardiol. 2012 Sep-Oct;28(5):611.e1-3. doi: 10.1016/j.cjca.2012.03.006. Epub 2012 May 17.
In inoperable or high-risk patients with severe aortic stenosis, transcatheter aortic valve implantation (TAVI) provides an efficacious and safe alternative to surgical aortic valve replacement. In this case report, TAVI resulted in aortic valve cusp shearing and migration into the left main coronary artery, resulting in occlusion of coronary blood flow and cardiac arrest. The patient underwent immediate cardiopulmonary support and surgical intervention with a favourable outcome. With this case report, we illustrate the etiology and management of this complication, which can be recognized nonsurgically only if a high index of suspicion exists.
在无法手术或高危的重度主动脉瓣狭窄患者中，经导管主动脉瓣植入术（TAVI）为主动脉瓣置换术提供了一种有效且安全的替代方法。本病例报告中，TAVI 导致主动脉瓣叶撕裂并迁移到左主干冠状动脉，导致冠状动脉血流阻塞和心脏骤停。患者立即接受心肺支持和手术干预，结果良好。通过本病例报告，我们阐述了这种并发症的病因和处理方法，如果存在高度怀疑，这种并发症只能通过非手术方式识别。
