Munirathinam Ganesh Kumar, Kumar Bhupesh, Mishra Anand Kumar
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ann Card Anaesth. 2018 Apr-Jun;21(2):195-199. doi: 10.4103/aca.ACA_179_17.
Asymmetrical septal occluder device (ASOD) has made percutaneous closure of ventricular septal defect an easy and effective management option. Although there are reports of aortic and tricuspid valvular regurgitation after deployment of ASOD, only few cases of tricuspid stenosis (TS) has been reported so far in the literature. We report a case of malaligned ASOD that occurred after successful device closure resulting in TS along with mild tricuspid and aortic regurgitation requiring surgical retrieval. Transesophageal echocardiography played crucial role in detecting the cause of tricuspid valve dysfunction besides providing continuous monitoring during the procedure. We intend to emphasize the need of echocardiographic evaluation of the tricuspid valvular apparatus and aortic valve during and after the device deployment even after the successful device closure to prevent this rare complication.
不对称性室间隔封堵器（ASOD）使经皮闭合室间隔缺损成为一种简便有效的治疗选择。尽管有报道称ASOD植入后出现主动脉瓣和三尖瓣反流，但迄今为止，文献中仅报道了少数三尖瓣狭窄（TS）病例。我们报告一例在成功进行封堵器闭合术后发生的ASOD位置不当病例，导致TS以及轻度三尖瓣和主动脉瓣反流，需要通过手术取出封堵器。经食管超声心动图除了在手术过程中提供持续监测外，在检测三尖瓣功能障碍的原因方面发挥了关键作用。我们旨在强调，即使封堵器成功闭合，在封堵器植入期间及之后，也需要对三尖瓣装置和主动脉瓣进行超声心动图评估，以预防这种罕见的并发症。
