Lee Justin Z, Tey Kai R, Mizyed Ahmad, Hennemeyer Charles T, Janardhanan Rajesh, Lotun Kapildeo
Department of Internal Medicine, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA.
Department of Cardiovascular Diseases, University of Arizona, 1501 N. Campbell Avenue, RM 6336, Tucson, AZ, 85724-5040, USA.
BMC Cardiovasc Disord. 2015 Oct 9;15:119. doi: 10.1186/s12872-015-0108-z.
Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement.
We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation.
Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.
左心室流出道（LVOT）梗阻和瓣周漏（PVL）相对少见，但却是人工瓣膜置换术的严重并发症。
我们报告一例患者，该患者在接受主动脉瓣和二尖瓣置换术（MVR）后出现LVOT梗阻和二尖瓣PVL，展示了治疗此类患者所面临的独特治疗挑战。我们还描述了使用酒精间隔消融术和白蛋白-戊二醛（BioGlue）进行间隔消融，以经皮治疗患者的LVOT梗阻，随后使用Amplatzer血管封堵器经皮闭合与严重反流相关的二尖瓣前内侧PVL。
对于这些病症，经皮介入治疗可被视为初始治疗选择，尤其是对于再次手术具有高发病率和死亡率的高危患者。
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