Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
Ann Thorac Surg. 2020 Jun;109(6):e431-e433. doi: 10.1016/j.athoracsur.2019.09.079. Epub 2019 Nov 21.
An 87-year-old man with a hostile ascending aorta who underwent transfemoral transcatheter aortic valve replacement (TAVR) using a 26-mm Sapien 3 valve (Edwards Lifesciences, Irvine, CA) 2 years earlier presented with chronic type A aortic dissection, which was retrospectively caused by the edge of the pusher of the TAVR implantation system. Redo sternotomy and extraction of the Sapien valve, followed by replacement of the ascending aorta and the aortic valve, were performed successfully. Retrospective image analysis showed the importance of respecting the anatomy of the ascending aorta before considering transfemoral TAVR.
一位 87 岁的男性，2 年前因升主动脉呈敌视性而行经股动脉经导管主动脉瓣置换术（TAVR），使用 26 毫米的 Sapien 3 瓣膜（爱德华生命科学公司，欧文，加利福尼亚州）。患者此次因慢性 A 型主动脉夹层就诊，该夹层由 TAVR 植入系统的推送器边缘引起。再次行胸骨切开术并取出 Sapien 瓣膜，随后成功替换升主动脉和主动脉瓣。回顾性图像分析显示，在行经股 TAVR 之前，尊重升主动脉解剖结构的重要性。
