Fanari Zaher, Hammami Sumaya, Goswami Nilesh J, Goldstein Jeffrey A
Division of Cardiology, Prairie Heart Institute, Springfield, Illinois.
Catheter Cardiovasc Interv. 2017 Nov 1;90(5):806-808. doi: 10.1002/ccd.27130. Epub 2017 May 22.
Transcaval aortic access has been used for deployment of transcatheter aortic valves in patients in whom conventional arterial approaches are not feasible. This access can be vital in other situation when large bore access is needed. We described a case of 65-year-old man who had large thoracic descending aortic aneurysm with diffuse bilateral iliac disease precluding the arterial access required for the procedure. The patient underwent successful transcaval access with placement of 22-Fr balloon expandable sheath followed with successful deployments of 32 mm × 32 mm × 150 mm Valiant stent graft (Medtronic, Minneapolis, MN). The aorto-vena cava tract was closed successfully using 12 × 10 PDA occluder device with no residual flow at the end of the case, which was confirmed on repeated CT next day.
经腔静脉主动脉入路已被用于在常规动脉入路不可行的患者中部署经导管主动脉瓣。在其他需要大口径入路的情况下，这种入路可能至关重要。我们描述了一例65岁男性患者，该患者患有降主动脉瘤，双侧髂动脉弥漫性病变，无法进行该手术所需的动脉入路。患者成功进行了经腔静脉入路，置入了22F球囊扩张鞘，随后成功置入了32mm×32mm×150mm的Valiant支架移植物（美敦力公司，明尼阿波利斯，明尼苏达州）。使用12×10的动脉导管未闭封堵器成功封闭了主动脉-腔静脉通道，病例结束时无残余血流，次日重复CT检查证实了这一点。
