复杂主动脉瓣再次手术中的心脏直视经导管主动脉瓣置换术：病例系列报道
Open-heart transcatheter aortic valve replacement in complex aortic valve reoperation: about a case series.
作者信息
Leveille Laury, Jaussaud Nicolas, Theron Alexis, Riberi Alberto, Collart Frederic
机构信息
Department of Cardiac Surgery, La Timone Hospital, Marseille, 264 rue Saint Pierre, Marseille, France.
出版信息
Eur Heart J Case Rep. 2018 May 24;2(2):yty064. doi: 10.1093/ehjcr/yty064. eCollection 2018 Jun.
INTRODUCTION
Aortic homograft and stentless aortic root are helpful in acute infective endocarditis of the aortic valve as biological conduit when total root replacement is required. Reoperation for failure of aortic homograft and stentless aortic root remains challenging for the surgeon as the entire root can be heavily calcified.
CASE PRESENTATION
Here, are reported, three cases of patients successfully treated with open-heart transcatheter aortic valve replacement (TAVR) whereas no other prosthesis was implantable due to a massively calcified homograft or stentless prosthesis.
DISCUSSION
Open-heart TAVR avoided the risk of complete root replacement which is higher than redo aortic valve replacement (AVR). This rescue technique facilitated risky surgical procedure by combining the strengths of both TAVR and conventional AVR.
引言
当需要进行全根部置换时，主动脉同种异体移植物和无支架主动脉根部作为生物管道，有助于治疗主动脉瓣急性感染性心内膜炎。由于整个根部可能严重钙化，对主动脉同种异体移植物和无支架主动脉根部功能衰竭进行再次手术，对外科医生来说仍然具有挑战性。
病例报告
本文报告了3例患者，因同种异体移植物或无支架假体大量钙化，无法植入其他假体，成功接受了心脏直视经导管主动脉瓣置换术（TAVR）。
讨论
心脏直视TAVR避免了全根部置换的风险，全根部置换的风险高于再次主动脉瓣置换术（AVR）。这种挽救技术结合了TAVR和传统AVR的优势，简化了高风险的外科手术。
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