Yokoyama Yuichiro, Abe Mitsunori, Fujieda Hiroyuki, Abe Yumiko
Yotsuba Circulation Clinic, Minami-edo 4-3-53, Matsuyama, Ehime, 790-0062, Japan.
Gen Thorac Cardiovasc Surg. 2016 Oct;64(10):618-20. doi: 10.1007/s11748-015-0532-0. Epub 2015 Feb 22.
A 51-year-old woman was diagnosed as severe stenosed tricuspid bioprosthetic valve. She had developed an encephalopathy due to elevated serum ammonia concentration caused by congestive hepatic failure. Re-tricuspid valve replacement was deemed too risky, and balloon bioprosthetic valvuloplasty was instead planned. This procedure was successfully performed using a standard mitral valvuloplasty protocol. The 30-mm INOUE-BALLOON was inflated five times. The mean pressure gradient across the bioprosthetic valve decreased from 7.8 to 3.5 mmHg, and the tricuspid valve orifice area increased from 1.09 to 3.13 cm(2), without worsening of the tricuspid valve regurgitation. Finally, her hepatic encephalopathy was dramatically improved.
一名51岁女性被诊断为严重狭窄的三尖瓣生物瓣膜。她因充血性肝衰竭导致血清氨浓度升高而出现脑病。再次进行三尖瓣置换被认为风险太大，因此计划进行球囊生物瓣膜成形术。该手术使用标准的二尖瓣成形术方案成功完成。30毫米的INOUE球囊充气5次。生物瓣膜两端的平均压力梯度从7.8毫米汞柱降至3.5毫米汞柱，三尖瓣口面积从1.09平方厘米增加到3.13平方厘米，且三尖瓣反流未加重。最后，她的肝性脑病得到显著改善。
