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保留主动脉瓣的手术——肝移植受者的持久选择。

Aortic valve-sparing procedure-a durable choice in liver transplantation recipient.

机构信息

Sezione Autonoma Di Cardiochirurgia Universitaria, Section of Cardiac Surgery, Pisa University Hospital, Via Paradisa, 2, 56124, Pisa, Italy.

Liver Transplant Surgery Unit, Pisa University Hospital, Pisa, Italy.

出版信息

Gen Thorac Cardiovasc Surg. 2021 Feb;69(2):343-345. doi: 10.1007/s11748-020-01434-y. Epub 2020 Jul 12.

DOI:10.1007/s11748-020-01434-y
PMID:32656707
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7868313/
Abstract

A 44-year old man with aortic regurgitation and aneurysm of the ascending aorta underwent an aortic valve-sparing procedure as a durable treatment before liver transplantation. Since patients with chronic liver failure are at high risk of hemorrhagic complications at time of major surgery, while management of warfarin administration may still represent a concern, the choice of a cardiac procedure which avoids any anticoagulant treatment appeared justified.

摘要

一位 44 岁男性因主动脉瓣反流和升主动脉瘤而行主动脉瓣保留手术，作为肝移植前的持久治疗。由于慢性肝功能衰竭患者在大手术时存在出血并发症的高风险，而华法林管理可能仍然是一个关注点，因此选择避免任何抗凝治疗的心脏手术似乎是合理的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a703/7868313/30fb32b3a23e/11748_2020_1434_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a703/7868313/30fb32b3a23e/11748_2020_1434_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a703/7868313/30fb32b3a23e/11748_2020_1434_Fig1_HTML.jpg

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Aortic valve-sparing procedure-a durable choice in liver transplantation recipient.保留主动脉瓣的手术——肝移植受者的持久选择。
Gen Thorac Cardiovasc Surg. 2021 Feb;69(2):343-345. doi: 10.1007/s11748-020-01434-y. Epub 2020 Jul 12.
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Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta.改良管道制备在保留主动脉瓣的升主动脉瘤手术中创建一个假窦。
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本文引用的文献

1
TAVR at 5 Years - Rematch or Swan Song for Surgery?经导管主动脉瓣置换术5年随访——手术的再次较量还是终曲？
N Engl J Med. 2020 Feb 27;382(9):867-868. doi: 10.1056/NEJMe2000240.
2
Failure of valve-in-valve implantation for pure aortic regurgitation.单纯主动脉瓣反流的瓣中瓣植入失败
Asian Cardiovasc Thorac Ann. 2020 Feb;28(2):131. doi: 10.1177/0218492319899575. Epub 2019 Dec 31.
3
Management of Coagulation and Anticoagulation in Liver Transplantation Candidates.肝移植候选者的凝血和抗凝管理。
Liver Transpl. 2018 Aug;24(8):1119-1132. doi: 10.1002/lt.25198.
4
Surgical Treatment of Annuloaortic Ectasia - Replace or Repair?主动脉瓣环扩张症的外科治疗——置换还是修复？
Aorta (Stamford). 2017 Oct 1;5(5):139-147. doi: 10.12945/j.aorta.2017.17.044. eCollection 2017 Oct.
5
Post-Operative Hemorrhage After Liver Transplantation: Risk Factors and Long-Term Outcome.肝移植术后出血：危险因素与长期预后
Ann Transplant. 2016 Jan 28;21:46-55. doi: 10.12659/aot.895605.
6
Transcatheter aortic valve replacement for native aortic valve regurgitation as a bridge to liver transplantation.经导管主动脉瓣置换术用于原发性主动脉瓣反流作为肝移植的桥梁。
Catheter Cardiovasc Interv. 2016 Oct;88(4):665-670. doi: 10.1002/ccd.26264. Epub 2015 Oct 1.
7
Current readings: Aortic valve-sparing operations.当前读数：保留主动脉瓣手术。
Semin Thorac Cardiovasc Surg. 2014 Autumn;26(3):231-8. doi: 10.1053/j.semtcvs.2014.10.002. Epub 2014 Nov 11.
8
Aortic balloon valvuloplasty prior to orthotopic liver transplantation: a novel approach to aortic stenosis and end-stage liver disease.原位肝移植前的主动脉球囊瓣膜成形术：一种治疗主动脉瓣狭窄和终末期肝病的新方法。
Case Rep Cardiol. 2014;2014:325136. doi: 10.1155/2014/325136. Epub 2014 Nov 9.
9
How to perform valve sparing reimplantation in a tricuspid aortic valve.如何在三尖瓣主动脉瓣中进行瓣膜保留再植入。
Ann Cardiothorac Surg. 2013 Jan;2(1):105-12. doi: 10.3978/j.issn.2225-319X.2013.01.16.
10
Long-term management of the successful adult liver transplant: 2012 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation.成人肝移植成功后的长期管理：美国肝病研究协会和美国移植学会2012年实践指南
Liver Transpl. 2013 Jan;19(1):3-26. doi: 10.1002/lt.23566.