Naganuma Toru, Mitomo Satoru, Nakamura Shotaro, Akita Masafumi, Nakao Tatsuya, Nakamura Sunao
Department of Cardiology, New Tokyo Hospital, Japan.
Intern Med. 2016;55(11):1459-61. doi: 10.2169/internalmedicine.55.6238. Epub 2016 Jun 1.
An 84-year-old woman was diagnosed with symptomatic severe aortic stenosis. She had previously undergone aortobifemoral bypass grafting (Y graft) for bilateral iliac stenosis. In view of a high surgical risk, a decision for transcatheter aortic valve implantation (TAVI) was made. An incision was made on the right limb of the Y graft and subsequently a 16 Fr e-sheath was smoothly advanced through the graft. A 23 mm balloon expandable valve was then advanced with no resistance and successfully deployed. This case highlights the feasibility of TAVI through the graft, but requires a thorough preprocedural assessment of the access route using multiple imaging modalities.
一名84岁女性被诊断为有症状的严重主动脉瓣狭窄。她此前因双侧髂动脉狭窄接受了主动脉双股动脉搭桥术（Y型搭桥）。鉴于手术风险高，决定进行经导管主动脉瓣植入术（TAVI）。在Y型搭桥的右肢做了一个切口，随后一个16 Fr的e鞘管顺利通过搭桥推进。然后一个23毫米的球囊扩张瓣膜毫无阻力地推进并成功展开。该病例突出了通过搭桥进行TAVI的可行性，但需要在术前使用多种成像方式对入路进行全面评估。
