出乎意料：左心室流出道梗阻情况下的经导管主动脉瓣置换术。
Contrary to Expectations: Off-Label Transcatheter Aortic Valve Replacement in the Case of Left Ventricular Outflow Tract Obstruction.
机构信息
Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
出版信息
Can J Cardiol. 2019 Feb;35(2):229.e5-229.e6. doi: 10.1016/j.cjca.2018.12.007. Epub 2018 Dec 12.
We present the case of a 71-year-old woman who showed recurrent signs of congestive heart failure with the need of rehospitalization after double valve (mitral and aortic) replacement. Extensive diagnostic workup revealed a moderate aortic stenosis and additionally a significant left ventricular outflow tract obstruction. The tissue overgrowth might be attributed to an inflammatory reaction with extensive pannus deposit after aortic valve surgery. With no-option for re-do surgery we performed the first-in-man off-label valve-in-left ventricular outflow tract procedure with an Edwards Sapien III 23 mm in deep orientation.
我们报告了一例 71 岁女性病例，她在接受二尖瓣和主动脉瓣双瓣置换术后反复出现充血性心力衰竭征象，并需要再次住院治疗。广泛的诊断检查显示中度主动脉瓣狭窄，此外还存在明显的左心室流出道梗阻。组织过度生长可能归因于主动脉瓣手术后的炎症反应和广泛的瓣叶赘生物沉积。由于没有再次手术的选择，我们在首例患者中进行了经心尖入路的、Edwards Sapien III 23 瓣膜的、非适应证的左心室流出道植入术，采用了深植入位。
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