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涤纶带内缠绕的金属丝在经导管三尖瓣环成形术中的处理-如何解决这个问题。

Tangled wire in a Dacron band during Cardioband transcatheter tricuspid annuloplasty-How to solve the problem.

机构信息

University Heart Center Zurich, Zürich, Switzerland.

出版信息

Catheter Cardiovasc Interv. 2021 Apr 1;97(5):E724-E726. doi: 10.1002/ccd.28845. Epub 2020 Mar 10.

Abstract

Transcatheter tricuspid valve intervention (TTVI) is an emerging treatment for patients with symptomatic severe tricuspid regurgitation (TR). Currently, the issues that arise during TTVI are unclear. Here, a 78-year-old woman with severe TR underwent transcatheter tricuspid valve annuloplasty using a Cardioband (Edwards Lifesciences, Irvine, CA). We attempted to cinch the Dacron band after anchoring; however, it was impossible to connect the distal tip of the size adjustment tool and the Dacron band because the cinching wire was tangled around the Dacron band. We resolved this issue without surgical intervention, and eventually cinched the annulus. Final echocardiography revealed dramatic TR reduction. To our knowledge, no study has reported a tangled wire in a Dacron band during Cardioband use. Clinicians should be aware of the risks accompanying this concern in case where it is impossible to connect the distal tip of the size adjustment tool and the Dacron band during cinching.

摘要

经导管三尖瓣介入治疗(TTVI)是一种治疗症状性严重三尖瓣反流(TR)的新兴方法。目前,TTVI 过程中出现的问题尚不清楚。在这里,一名 78 岁的女性因严重 TR 接受了使用 Cardioband(爱德华兹生命科学公司,欧文,CA)进行的经导管三尖瓣瓣环成形术。我们试图在锚固后收紧涤纶带;然而,由于收紧丝缠绕在涤纶带上,无法连接尺寸调整工具的远端尖端和涤纶带。我们在没有手术干预的情况下解决了这个问题,并最终收紧了瓣环。最终的超声心动图显示 TR 显著减少。据我们所知,在使用 Cardioband 时,没有研究报告涤纶带中出现缠绕的金属丝。如果在收紧过程中无法连接尺寸调整工具的远端尖端和涤纶带,临床医生应该意识到这一问题带来的风险。

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