Tamuno Peace, Nair Rajesh, Nunn Chris, Devlin Gerard
Department of Cardiology, Waikato Hospital, Hamilton, New Zealand.
BMJ Case Rep. 2014 Oct 15;2014:bcr2014204757. doi: 10.1136/bcr-2014-204757.
A 68-year-old woman was transferred from a regional hospital with recurrent polymorphic ventricular tachycardia associated with haemodynamic instability. A diagnosis of severe aortic stenosis (AS) with normal left ventricular systolic function had recently been established on echocardiography. Correction of hypokalaemia and intravenous amiodarone infusion were ineffective. On transfer, ongoing ventricular arrhythmias requiring repeat defibrillation occurred. Urgent coronary angiography was unremarkable. Following consultation with the cardiosurgical team, emergency bridging balloon aortic valvuloplasty (BAV) was performed. Two weeks later the patient proceeded to an uneventful inpatient surgical aortic valve replacement (AVR). This case highlights an unusual presentation of severe AS, and describes the use of emergency BAV to correct arrhythmia-induced haemodynamic instability prior to surgical AVR.
一名68岁女性从一家地区医院转来，患有复发性多形性室性心动过速并伴有血流动力学不稳定。最近经超声心动图检查确诊为严重主动脉瓣狭窄（AS），左心室收缩功能正常。纠正低钾血症和静脉输注胺碘酮均无效。转院时，持续发生室性心律失常，需要反复除颤。紧急冠状动脉造影未见异常。在与心脏外科团队会诊后，进行了紧急桥接球囊主动脉瓣成形术（BAV）。两周后，患者顺利接受了住院手术主动脉瓣置换术（AVR）。该病例突出了严重AS的一种不寻常表现，并描述了在手术AVR之前使用紧急BAV纠正心律失常引起的血流动力学不稳定的情况。
