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经导管主动脉瓣植入术：使用自膨胀装置治疗左心室辅助装置植入术后的主动脉瓣反流

TAVI Using a Self-Expandable Device for Aortic Regurgitation Following LVAD Implantation.

作者信息

Sarwari Harun, Schaefer Andreas, Barten Markus J, Conradi Lenard

机构信息

Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.

出版信息

Thorac Cardiovasc Surg Rep. 2019 Jan;8(1):e33-e36. doi: 10.1055/s-0039-1698412. Epub 2019 Nov 4.

DOI:10.1055/s-0039-1698412
PMID:31692909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6828560/
Abstract

In patients treated by left ventricular assist device (LVAD), aortic regurgitation (AR) may occur. Secondary surgery to correct AR is considered high risk.  We report a case of severe AR following LVAD implantation in a patient who was subsequently treated by transcatheter aortic valve implantation (TAVI) using the latest generation self-expandable transcatheter heart valve (THV) (Boston Scientific Acurate neo, size M [Boston Scientific, Marlborough, Massachusetts, United States]). TAVI followed modified procedural protocol and sizing algorithm. THV implantation without prior balloon aortic valvuloplasty resulted in an adequate valve function without leakage.  This THV may be particularly well suited for TAVI subsequent to LVAD implantation if modified sizing and deployment considerations are appreciated.

摘要

在接受左心室辅助装置（LVAD）治疗的患者中，可能会发生主动脉瓣反流（AR）。纠正AR的二次手术被认为风险很高。 我们报告了1例LVAD植入术后发生严重AR的患者，该患者随后使用最新一代自膨胀经导管心脏瓣膜（THV）（波士顿科学公司的Acurate neo，型号M [美国马萨诸塞州马尔伯勒市波士顿科学公司]）接受了经导管主动脉瓣植入术（TAVI）治疗。TAVI遵循改良的手术方案和尺寸计算方法。未先行球囊主动脉瓣成形术的THV植入术产生了功能良好且无渗漏的瓣膜。 如果认识到尺寸调整和植入方面的改良因素，这种THV可能特别适合LVAD植入术后的TAVI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c9/6828560/4bc34cce9dd6/10-1055-s-0039-1698412-i190339crc-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c9/6828560/4a576fef0066/10-1055-s-0039-1698412-i190339crc-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c9/6828560/4bc34cce9dd6/10-1055-s-0039-1698412-i190339crc-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c9/6828560/4a576fef0066/10-1055-s-0039-1698412-i190339crc-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c9/6828560/4bc34cce9dd6/10-1055-s-0039-1698412-i190339crc-2.jpg

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本文引用的文献

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Cardiology. 2018;141(3):132-140. doi: 10.1159/000491919. Epub 2018 Dec 5.
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Transfemoral Implantation of the Acurate neo for the Treatment of Aortic Regurgitation.经股动脉植入Acurate neo治疗主动脉瓣反流
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Transcatheter Aortic Valve Replacement for Native Aortic Valve Regurgitation.经导管主动脉瓣置换术治疗原发性主动脉瓣反流
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