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病例报告:瓣周漏作为心房颤动经皮导管消融的并发症

Case report: paravalvular leak as a complication of percutaneous catheter ablation for atrial fibrillation.

作者信息

Gurbuz Orcun, Ercan Abdulkadir, Ozkan Hakan, Kumtepe Gencehan, Karal Ilker H, Ener Serdar

机构信息

Department of Cardiovascular Surgery, Balikesir University, School of Medicine, Balikesir, 10010, Turkey.

Department Of Cardiology, Bahcesehir University Faculty of Medicine, Istanbul, Turkey.

出版信息

J Cardiothorac Surg. 2014 Dec 17;9:187. doi: 10.1186/s13019-014-0187-4.

DOI:10.1186/s13019-014-0187-4
PMID:25515423
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4279701/
Abstract

An increasing number of reports reveal the safety and efficacy of catheter ablation for atrial fibrillation therapy even in patients with a history of prosthetic heart valve. This case report presents a 60 year old female patient who had a prosthetic mitral paravalvular leak as a complication of radiofrequency ablation. Surgery revealed a 15 mm hole and three broken knots in the posterolateral mitral annulus. This report demonstrates radiofrequency ablation for atrial fibrillation in patients with prosthetic mitral valve may cause a paravalvular leak likely as a result of thermal injury. Moreover, patient can be asymptomatic at first. The clinician should keep in mind such complication and the patient should be evaluated in terms of paravalvular leakage.

摘要

越来越多的报告显示,即使是有心脏人工瓣膜病史的患者,导管消融治疗心房颤动也具有安全性和有效性。本病例报告介绍了一名60岁女性患者,她因射频消融术出现人工二尖瓣瓣周漏并发症。手术发现二尖瓣后外侧瓣环有一个15毫米的洞和三个断结。本报告表明,人工二尖瓣患者进行房颤射频消融可能会因热损伤导致瓣周漏。此外,患者起初可能无症状。临床医生应牢记此类并发症,应对患者进行瓣周漏评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/e8a32efa04ba/13019_2014_Article_187_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/e568a2da9f0c/13019_2014_Article_187_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/31feee02f287/13019_2014_Article_187_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/e8a32efa04ba/13019_2014_Article_187_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/e568a2da9f0c/13019_2014_Article_187_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/31feee02f287/13019_2014_Article_187_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ade/4279701/e8a32efa04ba/13019_2014_Article_187_Fig3_HTML.jpg

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2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.2014年美国心脏协会/美国心脏病学会/心律学会心房颤动患者管理指南:美国心脏病学会/美国心脏协会实践指南工作组及心律学会的报告
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2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.2024 年欧洲心脏节律协会/心律学会/亚太心脏节律学会/拉丁美洲心脏节律学会专家共识声明:导管和手术消融治疗心房颤动。
Europace. 2024 Mar 30;26(4). doi: 10.1093/europace/euae043.
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2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary.2017年心房颤动导管消融与外科消融治疗专家共识声明:执行摘要(由心律学会[HRS]、欧洲心律协会[EHRA]、欧洲心血管病预防与康复协会[ECAS]、亚太心律学会[APHRS]及拉丁美洲心律学会[SOLAECE]联合发布)
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