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从三尖瓣到双孔形态:在先天性矫正型大动脉转位中使用MitraClip装置进行经皮三尖瓣反流修复。

From tricuspid to double orifice Morphology: Percutaneous tricuspid regurgitation repair with the MitraClip device in congenitally corrected-transposition of great arteries.

作者信息

Picard Fabien, Tadros Victor-Xavier, Asgar Anita W

机构信息

Department of Medicine, Interventional Cardiology, Montreal Heart Institute, Université de Montréal, Montréal, QC, Canada.

出版信息

Catheter Cardiovasc Interv. 2017 Sep 1;90(3):432-436. doi: 10.1002/ccd.26834. Epub 2016 Nov 10.

DOI:10.1002/ccd.26834
PMID:27860182
Abstract

Edge to edge transcatheter mitral valve repair with MitraClip (Abbott Vascular, Menlo Park, CA) is increasing for high-risk surgical patients with significant mitral regurgitation. Patients with congenitally corrected transposition of the great arteries (CCTGA) presenting with tricuspid valve regurgitation of a systemic right ventricle may represent particularly challenging candidates for MitraClip given their anatomy. We report the case of a 67-year-old gentleman with CCTGA and severe tricuspid regurgitation who was referred for MitraClip implantation after heart team consensus. Successful implantation of one clip was performed, achieving a significant reduction of the regurgitation. Similarly, favorable findings were confirmed at 6 months, 1 and 2 years follow-up and the patient had no recurrent heart failure admissions after 2-year follow-up. We describe the technical considerations and the importance of 3D-transoesophageal echocardiography for performing the MitraClip of a trileaflet systemic atrioventricular valve. © 2016 Wiley Periodicals, Inc.

摘要

对于有严重二尖瓣反流的高危外科手术患者,使用MitraClip(雅培血管,加利福尼亚州门洛帕克)进行边对边经导管二尖瓣修复术的应用正在增加。患有先天性矫正型大动脉转位(CCTGA)且系统性右心室出现三尖瓣反流的患者,鉴于其解剖结构,可能是MitraClip特别具有挑战性的候选对象。我们报告了一例67岁患有CCTGA和严重三尖瓣反流的男性患者,经心脏团队会诊后转诊进行MitraClip植入。成功植入一个夹子,使反流显著减少。同样,在6个月、1年和2年随访时均证实了良好的结果,并且该患者在2年随访后没有再次因心力衰竭入院。我们描述了进行三叶系统性房室瓣MitraClip操作的技术要点以及三维经食管超声心动图的重要性。© 2016威利期刊公司

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