Schnittman Samuel R, Weiss Aaron J, Varghese Robin, Stelzer Paul
Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic correspondence:
J Heart Valve Dis. 2017 Sep;26(5):600-602.
A 36-year-old pregnant woman with a history of rheumatic heart disease and prior aortic valve replacement and mitral valve repair presented to an outside hospital with severe aortic stenosis. The patient had a cardiac arrest upon labor induction and underwent a transcatheter aortic valve replacement (TAVR), which dislodged two days later. Five months later, the patient underwent removal of the dislodged TAVR and a Ross procedure at the authors' institution. The patient was stable upon discharge, with minimal aortic and pulmonary regurgitation. To the authors' knowledge, the present report is the first of the Ross procedure being used under such circumstances. It is suggested that caution be taken when using bioprosthetic and transcatheter aortic valves in young patients, and primary use of the Ross procedure is encouraged at experienced centers.
一名36岁的孕妇，有风湿性心脏病史，曾接受主动脉瓣置换和二尖瓣修复手术，因严重主动脉瓣狭窄被送往外地一家医院。患者在引产时发生心脏骤停，接受了经导管主动脉瓣置换术（TAVR），但两天后瓣膜移位。五个月后，患者在作者所在机构接受了移位TAVR的取出及罗斯手术。患者出院时情况稳定，主动脉和肺动脉反流轻微。据作者所知，本报告是首次在这种情况下使用罗斯手术。建议在年轻患者中使用生物人工瓣膜和经导管主动脉瓣时要谨慎，鼓励在有经验的中心优先使用罗斯手术。
