Lamelas Joseph, Silva Guilherme V, Chatterjee Subhasis
From the Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery.
Division of Cardiology, Department of Medicine, and.
Innovations (Phila). 2018 May/Jun;13(3):222-225. doi: 10.1097/IMI.0000000000000496.
Mitral annular calcification can pose a formidable surgical challenge in the setting of mitral valve replacement for mitral stenosis. Although there are reports of transapical valve-in-valve transcatheter mitral valve replacement in the setting of degenerated bioprosthetic mitral valve replacement, there is less experience with transcatheter mitral valve replacement for mitral annular calcification. This report describes a patient who previously received a transcatheter aortic valve replacement and then subsequently underwent a minimally invasive right thoracotomy for transcatheter mitral valve replacement with a successful result. We discuss technical pearls and operative considerations based on an extensive experience with minimally invasive valve surgery from a right mini-thoracotomy.
在二尖瓣狭窄行二尖瓣置换术时，二尖瓣环钙化会带来巨大的手术挑战。尽管有关于在退化生物瓣二尖瓣置换情况下经心尖瓣中瓣经导管二尖瓣置换术的报道，但经导管二尖瓣置换术治疗二尖瓣环钙化的经验较少。本报告描述了一名患者，该患者先前接受了经导管主动脉瓣置换术，随后接受了微创右胸切口经导管二尖瓣置换术，结果成功。我们基于右胸小切口微创瓣膜手术的丰富经验，讨论技术要点和手术注意事项。
