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左主动脉窦起源异常右冠状动脉合并骨髓增生异常综合征患者的经导管主动脉瓣修复术

Transcatheter Aortic Valve Repair in a Patient With Anomalous Right Coronary Artery Originating From the Left Aortic Sinus and Myelodysplastic Syndrome.

作者信息

Birkl Katharina, Plank Fabian, Bonaros Nikos, Feuchtner Gudrun, Friedrich Guy

机构信息

Radiology, Medical University of Innsbruck, Innsbruck, AUT.

Cardiology, Medical University of Innsbruck, Innsbruck, AUT.

出版信息

Cureus. 2020 Jul 8;12(7):e9073. doi: 10.7759/cureus.9073.

DOI:10.7759/cureus.9073
PMID:32656049
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7348210/
Abstract

We report a patient with symptomatic low-flow high-grade aortic valve stenosis and myelodysplastic syndrome. Preinterventional imaging revealed an anomalous origin of the right coronary artery only defined by CT. The patient was classified as high risk in regard to conventional cardiac surgery by our heart team and therefore scheduled for transcatheter aortic valve repair (TAVR). The case presentation describes the potential effect of this anatomical coronary variant with regard to the peri- and postinterventional outcome: anomalous origin of the right coronary artery may lead to severe ischemia during TAVR due to occlusion of the coronary vessel. Conversion to open surgery with immediate coronary bypass surgery may rapidly restore myocardial perfusion and enhance clinical outcome of the patient.

摘要

我们报告了一名患有症状性低流量重度主动脉瓣狭窄和骨髓增生异常综合征的患者。介入治疗前的影像学检查仅通过CT发现右冠状动脉起源异常。我们的心脏团队将该患者归类为传统心脏手术的高风险患者，因此安排进行经导管主动脉瓣修复术（TAVR）。该病例报告描述了这种冠状动脉解剖变异对介入治疗期间及术后结果的潜在影响：右冠状动脉起源异常可能导致TAVR期间冠状动脉血管闭塞，从而引发严重缺血。转为立即进行冠状动脉搭桥手术的开放手术可能会迅速恢复心肌灌注并改善患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d99a/7348210/7d70fd439345/cureus-0012-00000009073-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d99a/7348210/7038ddf98d76/cureus-0012-00000009073-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d99a/7348210/7d70fd439345/cureus-0012-00000009073-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d99a/7348210/7038ddf98d76/cureus-0012-00000009073-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d99a/7348210/7d70fd439345/cureus-0012-00000009073-i03.jpg

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