Operative Unit of Cardiac Surgery, G Pasquinucci Hospital, G Monasterio Foundation, Massa, Italy.
Catheter Cardiovasc Interv. 2013 May;81(6):1075-8. doi: 10.1002/ccd.24540. Epub 2012 Jul 23.
Transcatheter valve-in-valve implantation is an emerging treatment option for high-risk patients with failing aortic bioprostheses. The presence of the prosthesis stents is thought to prevent coronary artery obstruction, a known complication of transcatheter aortic valve implantation in the native aortic valve. The Sorin Mitroflow aortic bioprosthesis (Sorin Group, Saluggia, Italy) has a particular design in that the pericardial leaflets are mounted outside the valve stent. As a consequence, the pericardial leaflets of this prosthesis may be displaced well away from the stents during the deployment of transcatheter valves. This might explain why both the cases of coronary occlusion following valve-in-valve implantation reported to date occurred in patients with a malfunctioning Mitroflow bioprosthesis. We describe a patient with a malfunctioning 25 mm Mitroflow bioprosthesis successfully treated by percutaneous transcatheter valve-in-valve implantation, and discuss the role that balloon aortic valvuloplasty plays in the performance of this delicate procedure.
经导管瓣中瓣植入术是一种新兴的治疗方法，适用于主动脉生物瓣功能不良的高危患者。假体支架的存在被认为可以防止冠状动脉阻塞，这是经导管主动脉瓣植入术在原生主动脉瓣中已知的并发症。Sorin Mitroflow 主动脉生物瓣（Sorin Group，Saluggia，意大利）具有特殊的设计，即心包瓣叶安装在瓣膜支架的外部。因此，在经导管瓣膜植入过程中，该假体的心包瓣叶可能会从支架上移位很远。这也许可以解释为什么迄今为止报告的两例瓣中瓣植入术后冠状动脉闭塞均发生在 Mitroflow 生物瓣功能不良的患者中。我们描述了一位 25 毫米 Mitroflow 生物瓣功能不良的患者，通过经皮经导管瓣中瓣植入术成功治疗，并讨论了球囊主动脉瓣成形术在这一精细手术中的作用。
