Castiglioni Alessandro, Pozzoli Alberto, Maisano Francesco, Alfieri Ottavio
Heart Surgery Unit, San Raffaele University Hospital, Milan, Italy.
Interact Cardiovasc Thorac Surg. 2012 Sep;15(3):553-4. doi: 10.1093/icvts/ivs230. Epub 2012 Jun 12.
Transcatheter aortic valve implantation (TAVI) was introduced five years ago (2007) as an alternative treatment for patients with severe aortic stenosis, who are considered at too high a risk for surgical replacement. Few cases of postoperative infection by TAVI device are reported in the literature. We report the case of a patient with Osler-Weber-Rendu (OWR) syndrome, in which the TAVI procedure was preferred at the outset to avoid the risk of bleeding. He was diagnosed with endocarditis on the TAVI device one year later; he then underwent an uneventful surgical aortic valve replacement. In these complex clinical cases it is difficult to determine a 'gold standard' treatment and the possibility of offering patients both the percutaneous treatment and the surgical replacement appears to be desirable. Correction of the valve disease improves the outcome, reducing the episodes of haemorrhage and the need for blood transfusions.
经导管主动脉瓣植入术（TAVI）于五年前（2007年）被引入，作为严重主动脉瓣狭窄患者的一种替代治疗方法，这些患者被认为进行外科瓣膜置换手术的风险过高。文献中报道的TAVI装置术后感染病例很少。我们报告了一例患有遗传性出血性毛细血管扩张症（OWR）综合征的患者，起初选择TAVI手术以避免出血风险。一年后，他被诊断为TAVI装置感染性心内膜炎；随后他顺利接受了外科主动脉瓣置换手术。在这些复杂的临床病例中，很难确定“金标准”治疗方法，为患者提供经皮治疗和外科置换两种选择似乎是可取的。纠正瓣膜疾病可改善预后，减少出血发作次数和输血需求。
