Division of Cardiology, Prairie Heart Institute, Springfield, Illinois.
Division of Cardiology, Heartland Cardiology/Wesley Medical Center, University of Kansas School of Medicine-Wichita, Wichita, Kansas.
Catheter Cardiovasc Interv. 2018 Nov 1;92(5):988-992. doi: 10.1002/ccd.27410. Epub 2017 Nov 6.
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management. We are reporting a case of an 83-year-old man with very symptomatic severe AS and severe native MS with associated severe MAC and moderate mitral regurgitation with high STS score who underwent a simultaneous transfemoral TAVR and transseptal TMVR with good results and great improvement in symptoms that was maintained on 10 months follow-up.
患有严重主动脉瓣狭窄(AS)和严重二尖瓣狭窄(MS)合并二尖瓣环钙化(MAC)的患者构成了一个老年高危人群,他们在出现严重瓣膜功能障碍之前就已经存在多种基线合并症。经导管二尖瓣置换术(TMVR)为伴有 MAC 的高危严重 MS 患者提供了一种替代选择。同期经股动脉经导管主动脉瓣置换术(TAVR)和经间隔 TMVR 是可行的,并且提供了最微创的管理方法。我们报告了一例 83 岁男性患者,他患有严重的症状性 AS 和严重的原发性 MS,伴有严重的 MAC 和中度二尖瓣反流,STS 评分较高,他接受了同期经股动脉 TAVR 和经间隔 TMVR,结果良好,症状得到极大改善,并在 10 个月的随访中得到维持。