UO Cardiologia Interventistica, Azienda ASL S. Camillo Forlanini, Circonvallazione Gianicolense, 87, 00152 Roma, Italy.
Heart Lung Circ. 2012 Dec;21(12):850-2. doi: 10.1016/j.hlc.2012.06.001. Epub 2012 Jul 9.
Percutaneous transcatheter closure of paravalvular leaks is an attractive treatment option in high risk symptomatic patients unsuitable for redo surgery. We present a case of a 64 year-old woman with double mechanical mitral and aortic valve prosthesis referred for a symptomatic mitral paravalvular leak. Because of the high surgical risk transcatheter closure of the defect was planned. The procedure was performed under real time 3D transoesophageal echocardiographic guidance via trans-septal approach. An Amplatzer Vascular Plug III 14 × 3 mm was implanted using an arteriovenous wire loop established through the aortic valve prosthesis. A transient dysfunction of the mitral prosthesis occurred, but it resolved spontaneously within few hours. Transcatheter paravalvular leak closure with an arteriovenous wire loop across a mechanical aortic valve prosthesis has never been described. We discuss the main technical issues.
经皮导管介入术治疗瓣周漏在高危症状性患者中具有吸引力，这些患者不适合再次手术。我们报告了一例 64 岁女性，患有双机械二尖瓣和主动脉瓣假体，因症状性二尖瓣瓣周漏而被转诊。由于手术风险高，计划进行经导管缺陷封堵。该程序在实时 3D 经食道超声心动图引导下经房间隔途径进行。通过经主动脉瓣假体建立的动静脉线环植入了一个 Amplatzer 血管塞 III 14×3mm。二尖瓣假体短暂功能障碍，但在数小时内自发恢复。经导管瓣周漏封堵术，通过动静脉线环穿过机械主动脉瓣假体，尚未有报道。我们讨论了主要的技术问题。
