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[癌症患者经皮腔内球囊主动脉瓣成形术(PTAV)后复发性主动脉瓣狭窄的主动脉瓣置换术]

[Aortic valve replacement for recurrent aortic stenosis after percutaneous transluminal balloon aortic valvuloplasty( PTAV) in a cancer patient].

作者信息

Kobayashi Kensuke, Suto Yukio, Akashi Okihiko, Sakata Yoshihito, Hayama Yasufumi

机构信息

Department of Cardiovascular Surgery, Ikegami General Hospital Heart Center, Tokyo, Japan.

出版信息

Kyobu Geka. 2014 Feb;67(2):105-8.

Abstract

We report a case of aortic valve replacement( AVR) for recurrent aortic stenosis(AS) after percutaneous transluminal balloon aortic valvuloplasty( PTAV) in a patient with left renal pelvis carcinoma. A 65-year-old female had been suffering from shortness of breath and syncope due to severe AS. She was considered to be a candidate for AVR. Preoperative examination revealed advanced left renal pelvis carcinoma that was a critical comorbidity for AVR. Ureteronephrectomy was also considered to be a contraindication. Despite conservative treatment, her condition was deteriorated. Emergency PTAV was performed when she was transferred to our hospital with circulatory shock. Her symptoms were ameliorated and left ureteronephrectomy was conducted 8 month after the PTAV. She was readmitted to our hospital 16 month after the PTAV and AVR was performed successfully.Antegrade transseptal PTAV is a very useful palliative therapy for AS with severe comorbidities as a bridge to surgery.

摘要

我们报告了一例左肾盂癌患者经皮腔内球囊主动脉瓣成形术(PTAV)后因复发性主动脉瓣狭窄(AS)而行主动脉瓣置换术(AVR)的病例。一名65岁女性因严重AS而出现呼吸急促和晕厥。她被认为是AVR的候选者。术前检查发现晚期左肾盂癌,这是AVR的严重合并症。输尿管肾切除术也被认为是禁忌症。尽管进行了保守治疗,她的病情仍恶化。当她因循环休克被转至我院时,进行了急诊PTAV。她的症状得到改善,并在PTAV后8个月进行了左输尿管肾切除术。PTAV后16个月,她再次入院并成功进行了AVR。顺行经中隔PTAV作为一种姑息治疗方法,对于合并严重疾病的AS患者而言,是通向手术的一座桥梁,非常有用。

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