Giannini Francesco, Ruparelia Neil, Del Furia Francesca, Romano Vittorio, Ancona Marco, Mangieri Antonio, Regazzoli Damiano, Latib Azeem, Godino Cosmo, Ancona Francesco, Candilio Luciano, Jabbour Richard, Colombo Antonio, Montorfano Matteo
Interventional Cardiology Unit, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy.
Interventional Cardiology Unit, San Raffaele Hospital, Milan, Italy.
Can J Cardiol. 2017 Jul;33(7):951.e1-951.e3. doi: 10.1016/j.cjca.2017.03.027. Epub 2017 Apr 8.
Although the rate of procedural complications during transcatheter aortic valve implantation has decreased because of technological advancement and increased operator experience, device embolization remains a rare but potentially fatal complication, even with new generation devices. We report, to our knowledge, the first case of Portico valve (St Jude Medical, Minneapolis, MN) migration despite apparent optimal initial implantation depth, which was retrieved using a novel strategy after failure of a traditional retrieval technique. We also describe a mechanism of left coronary artery systolic perfusion with diastolic backflow, which led to myocardial ischemia.
尽管由于技术进步和术者经验增加,经导管主动脉瓣植入术期间的手术并发症发生率有所下降,但即使使用新一代设备,器械栓塞仍然是一种罕见但可能致命的并发症。据我们所知,我们报告了首例尽管初始植入深度看似最佳,但Portico瓣膜(圣犹达医疗公司,明尼阿波利斯,明尼苏达州)仍发生移位的病例,在传统回收技术失败后,采用一种新颖的策略将其回收。我们还描述了一种左冠状动脉收缩期灌注伴舒张期逆流的机制,该机制导致了心肌缺血。