Jacobzon Ehud, Wolak Arik, Fink Danny, Silberman Shuli
Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Hebrew University of Jerusalem Medical School, Jerusalem, Israel.
Department of Cardiology, Shaare Zedek Medical Center, Hebrew University of Jerusalem Medical School, Jerusalem, Israel.
Catheter Cardiovasc Interv. 2019 Jun 1;93(7):E391-E393. doi: 10.1002/ccd.27994. Epub 2018 Nov 23.
We report a case of a 78-year-old female who presented with type A aortic dissection 22 months following transcatheter aortic valve implantation (TAVI). In addition, preoperative echocardiogram showed high gradients across the aortic prosthesis which was found to be thrombosed. At surgery, the intimal tear appeared to be non-acute and anatomically related to the rim of the valve cage. The thrombosed valve was not replaced and the patient received anticoagulation therapy following surgery with significant improvement in valve gradients.
我们报告一例78岁女性患者,在经导管主动脉瓣植入术(TAVI)22个月后出现A型主动脉夹层。此外,术前超声心动图显示主动脉人工瓣膜跨瓣压差较高,发现人工瓣膜有血栓形成。手术中,内膜撕裂似乎并非急性,且在解剖学上与瓣膜支架边缘相关。血栓形成的瓣膜未予更换,患者术后接受抗凝治疗,瓣膜压差有显著改善。