Watkins A Claire, Devireddy Chandan M, Al-Atassi Talal, Simone Amy E, Forcillo Jessica, Thourani Vinod H
Innovations (Phila). 2018 Mar/Apr;13(2):132-135. doi: 10.1097/IMI.0000000000000477.
A 74-year-old man presented with progressive dyspnea on exertion. History included peripheral arterial disease and coronary artery bypass grafting with aortic valve replacement 12 years ago. Subsequently, the surgical valve developed severe stenosis and moderate insufficiency. He underwent a transapical valve-in-valve transcatheter aortic valve replacement 5 years before presentation. This second valve developed a mean gradient of 66 mm Hg with mild insufficiency. The patient was treated with a third aortic valve using an alternative transcaval approach, significantly alleviating his symptoms.
一名74岁男性因进行性劳力性呼吸困难就诊。病史包括外周动脉疾病，12年前行冠状动脉旁路移植术并置换主动脉瓣。随后，手术置换的瓣膜出现严重狭窄和中度关闭不全。就诊前5年，他接受了经心尖瓣中瓣经导管主动脉瓣置换术。这第二个瓣膜出现平均压差66 mmHg伴轻度关闭不全。该患者采用另一种经腔静脉途径接受了第三次主动脉瓣置换治疗，症状明显缓解。
