Reiter Christian, Grund Michael, Nahler Alexander, Steinwender Clemens, Lambert Thomas
Department of Cardiology, Kepler University Hospital, Linz, Austria.
Department of Cardiology, Paracelsus Medical University, Salzburg, Austria.
Wien Klin Wochenschr. 2017 Dec;129(23-24):906-909. doi: 10.1007/s00508-017-1272-1. Epub 2017 Oct 4.
Transcatheter aortic valve replacement (TAVR) has been shown to be a valid treatment option for patients with significant symptomatic aortic valve stenosis and high surgical risk. Rupture of the aortic root is a rare but life-threatening complication that occurs in approximately 1% of procedures and usually manifests as an acute complication at the time of valve implantation; however, physicians should be aware of a potentially subacute onset, since early recognition and immediate management are crucial. While many potential causes have been described, it is currently unknown which combinations will lead to its occurrence. Accurate preprocedural assessment of the aortic annulus and its adjacent structures as well as adequate sizing of the prosthetic valve are important steps to prevent rupture of the device landing zone.
经导管主动脉瓣置换术（TAVR）已被证明是有严重症状性主动脉瓣狭窄且手术风险高的患者的有效治疗选择。主动脉根部破裂是一种罕见但危及生命的并发症，约1%的手术会发生，通常在瓣膜植入时表现为急性并发症；然而，医生应意识到可能有亚急性发作，因为早期识别和立即处理至关重要。虽然已描述了许多潜在原因，但目前尚不清楚哪些因素组合会导致其发生。术前准确评估主动脉瓣环及其相邻结构以及合适尺寸的人工瓣膜是防止装置着陆区破裂的重要步骤。
