Cigala Emanuele, Monteforte Ida, Piro Orlando, Monda Vittorio, Capozzolo Claudia, Bonzani Giulio
U.O.C. Cardiologia Interventistica, AORN dei Colli-Monaldi, Napoli.
G Ital Cardiol (Rome). 2017 Apr;18(4):325-328. doi: 10.1714/2683.27476.
Transcatheter aortic valve implantation (TAVI) is a validated technique for the treatment of aortic valve stenosis in patients with high surgical risk or inoperable. We present the case of an 80-year-old woman with severe aortic valve stenosis (mean gradient 55 mmHg), mild surgical risk, who refused traditional surgery. We implanted a Lotus Sadra 25 mm (Boston Scientific, Marlborough, MA, USA) via the transfemoral route. During pull back delivery, the patient experienced interscapular pain with angiographic evidence of type B aortic dissection effectively treated by implanting a vascular endoprosthesis Valiant 30 x 150 mm (Medtronic Vascular, Santa Rosa, CA, USA). Type B aortic dissection is a rare event during TAVI. The onset of procedural complications, often unpredictable, suggests the need for more extensive knowledge of materials and techniques, in particular with respect to endovascular treatment of the aortic and iliac-femoral district.
经导管主动脉瓣植入术（TAVI）是一种已获验证的治疗具有高手术风险或无法手术的主动脉瓣狭窄患者的技术。我们报告了一例80岁女性患者，患有严重主动脉瓣狭窄（平均压差55 mmHg），手术风险较低，但拒绝接受传统手术。我们通过经股动脉途径植入了一枚25 mm的Lotus Sadra（美国波士顿科学公司，马尔伯勒，马萨诸塞州）。在回撤输送过程中，患者出现肩胛间疼痛，血管造影显示为B型主动脉夹层，通过植入一枚30×150 mm的Valiant血管内假体（美国美敦力血管公司，圣罗莎，加利福尼亚州）得到有效治疗。B型主动脉夹层在TAVI期间是一种罕见事件。手术并发症的发生往往不可预测，这表明需要更广泛地了解材料和技术，尤其是在主动脉和髂股区的血管内治疗方面。
