Higa Shotaro, Nagano Takaaki, Yamashiro Satoshi, Iwabuchi Masashi
Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Asian Cardiovasc Thorac Ann. 2020 Jun;28(5):276-278. doi: 10.1177/0218492320930842. Epub 2020 Jun 1.
An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. After placement of the prosthetic valve, intraoperative transesophageal echocardiography revealed severe mitral regurgitation from the anterior mitral leaflet. Open conversion was performed immediately. A 5-mm hole was identified in the anterior leaflet, and direct closure was chosen for mitral valve repair. While transcatheter aortic valve replacement has gained popularity for patients with severe aortic stenosis and high operative risk, reports of mitral valve perforation are rare.
一名86岁重度主动脉瓣狭窄女性接受了经导管主动脉瓣置换术。使用了球囊扩张瓣膜，在双硬导丝引导下成功使主动脉变直。瓣膜置入过程中球囊移位。人工瓣膜置入后，术中经食管超声心动图显示二尖瓣前叶严重二尖瓣反流。立即进行了开胸转换。在前叶发现一个5毫米的孔，二尖瓣修复选择直接缝合。虽然经导管主动脉瓣置换术在重度主动脉狭窄且手术风险高的患者中越来越受欢迎，但二尖瓣穿孔的报道很少。
