Cohen Mabelle H, Kyriazis Dimitris K
Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of South Alabama College of Medicine, Mobile, Alabama 36617, USA.
Tex Heart Inst J. 2012;39(2):271-2.
Endovascular stents are being used with increasing frequency for various problems of the venous system, but they have been associated with numerous complications. We report the case of an 88-year-old woman who presented with persistent, progressive dyspnea. Imaging revealed a migrated stent lodged in the tricuspid valve and extending into the right ventricle, causing severe tricuspid regurgitation. After a failed attempt at endovascular retrieval, emergent surgical removal was successful. During surgery, the stent was found to be embedded in the tricuspid leaflets, and part of the stent had also perforated the right ventricle. Review of the patient's records revealed that 2 WALLSTENT venous endoprostheses had been placed 6 months earlier to treat stenosis of the left brachiocephalic vein and, further, that the migrated stent had been visible on outpatient chest radiography performed 4 months after the stent placement. This case emphasizes the need to consider the possibility of stent migration in patients who present with unusual symptoms.
血管内支架在静脉系统各种问题中的使用频率越来越高，但它们与众多并发症相关。我们报告了一例88岁女性患者，她出现持续性、进行性呼吸困难。影像学检查显示一个移位的支架卡在三尖瓣并延伸至右心室，导致严重的三尖瓣反流。在尝试血管内取出失败后，紧急手术取出成功。手术中发现支架嵌入三尖瓣小叶，部分支架还穿透了右心室。查阅患者记录发现，6个月前放置了2个WALLSTENT静脉内支架以治疗左头臂静脉狭窄，此外，移位的支架在支架置入后4个月的门诊胸部X线检查中就已可见。该病例强调，对于出现异常症状的患者，需要考虑支架移位的可能性。
