Kim Hongju, Lee Jung-Hee
Division of Cardiology, Yeungnam University Medical Center, Yeungnam University College of Medicine, 3170, Hyeonchung-ro, Nam-gu, Daegu, South Korea.
BMC Cardiovasc Disord. 2018 Mar 20;18(1):55. doi: 10.1186/s12872-018-0791-7.
Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome.
A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury. Transthoracic echocardiography (TTE) revealed low-flow, low-gradient AS with decreased left ventricular systolic function. With a diagnosis of acute decompensated heart failure combined with cardiorenal syndrome, we opted to perform emergent TAVR. Ultimately, we successfully performed emergent TAVR using only TTE and 3-D transesophageal echocardiography (TEE) measurements.
This report presents a case of decompensated severe AS accompanied by cardiorenal syndrome that was treated successfully with emergent TAVR. Thus, emergent TAVR using only echocardiography measurements is a feasible and safe option for treating decompensated heart failure accompanied by cardiorenal syndrome the clinical setting.
重度主动脉瓣狭窄（AS）可能导致对药物治疗耐药的急性失代偿性心力衰竭。在此，我们报告一例成功的急诊经导管主动脉瓣置换术（TAVR），该患者表现为失代偿性重度AS并伴有心肾综合征。
一名82岁男性因呼吸困难加重就诊于我院急诊科。胸部X线显示双侧肺水肿，实验室检查提示急性肾损伤。经胸超声心动图（TTE）显示低流量、低梯度AS伴左心室收缩功能下降。诊断为急性失代偿性心力衰竭合并心肾综合征后，我们选择进行急诊TAVR。最终，我们仅使用TTE和三维经食管超声心动图（TEE）测量成功实施了急诊TAVR。
本报告介绍了一例失代偿性重度AS伴心肾综合征患者经急诊TAVR成功治疗的病例。因此，仅使用超声心动图测量进行急诊TAVR是治疗临床环境中伴有心肾综合征的失代偿性心力衰竭的一种可行且安全的选择。
