Javaid Aamir, Tyerman Zachary, Beller Jared P, Ailawadi Gorav
Division of Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia.
J Card Surg. 2019 Nov;34(11):1370-1373. doi: 10.1111/jocs.14236. Epub 2019 Sep 2.
Transcatheter mitral valve replacement (TMVR) is an emerging treatment of mitral valve pathology in patients that are not candidates for conventional surgical approaches. Higher rates of left ventricular outflow tract obstruction (LVOTO) may occur following TMVR and its occurrence is an independent predictor of mortality. We present a case of severe mitral stenosis and annular calcification that was treated with a balloon-expandable Sapien S3 valve in the mitral position delivered through surgical port-access approach, which resulted in postoperative LVOTO. The LVOTO was successfully treated with alcohol septal ablation with immediate reduction in outflow tract gradients and long-term resolution.
经导管二尖瓣置换术（TMVR）是一种针对无法采用传统手术方法治疗的二尖瓣病变患者的新兴治疗手段。TMVR术后可能出现较高的左心室流出道梗阻（LVOTO）发生率，其发生是死亡率的独立预测因素。我们报告一例严重二尖瓣狭窄并瓣环钙化的病例，该病例通过经手术切口入路在二尖瓣位置植入球囊扩张式Sapien S3瓣膜进行治疗，术后出现了LVOTO。通过酒精间隔消融术成功治疗了LVOTO，流出道梯度立即降低，并获得了长期缓解。
