经导管主动脉瓣栓塞术后降主动脉破裂
Descending Aorta Rupture after Transcatheter Aortic Valve Embolization.
作者信息
Duque Santos África, Reyes Valdivia Andrés, Gallo González Pablo, González Ferrer Eduardo, Ocaña Guaita Julia, Gandarias Zúñiga Claudio
机构信息
Department of Vascular and Endovascular Surgery, Ramón y Cajal's University Hospital, Madrid, Spain.
Department of Vascular and Endovascular Surgery, Ramón y Cajal's University Hospital, Madrid, Spain.
出版信息
Ann Vasc Surg. 2018 May;49:312.e1-312.e4. doi: 10.1016/j.avsg.2017.11.042. Epub 2018 Feb 15.
BACKGROUND
To report a case of rupture of the descending aorta after aortic migration during transcatheter aortic valve replacement (TAVR).
METHODS
An 85-year-old man with a severe and symptomatic aortic stenosis underwent elective TAVR, which complicated with embolization into the ascending aorta. While repositioning into the descending aorta, the procedure complicated with aortic rupture.
RESULTS
The patient required urgent thoracic intravalve stent-graft implantation (thoracic endovascular aortic repair [TEVAR]). Reintervention with other stent graft was required 2 days after initial procedure as proximal rupture was again diagnosed. Patient was discharged 50 days later because of other medical complications. He remains stable at 1 year of follow-up.
CONCLUSIONS
TEVAR is a valid and safe option in the treatment of iatrogenic acute aortic rupture due to TAVR.
背景
报告1例经导管主动脉瓣置换术（TAVR）期间主动脉移位后降主动脉破裂的病例。
方法
1例85岁有症状的严重主动脉瓣狭窄男性患者接受择期TAVR，术中出现栓子栓塞至升主动脉。在重新定位至降主动脉的过程中，手术并发主动脉破裂。
结果
患者需要紧急行胸内瓣膜支架植入术（胸主动脉腔内修复术[TEVAR]）。初次手术后2天，因再次诊断近端破裂，需再次使用其他支架移植物进行干预。患者因其他医学并发症于50天后出院。随访1年，患者病情稳定。
结论
TEVAR是治疗TAVR所致医源性急性主动脉破裂的有效且安全的选择。
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