Kato Tomoki, Matayoshi Akira, Nakasone Toshiyuki
Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of The Ryukyus, Nishihara, Okinawa 903-0215, Japan.
Department of Oral and Maxillofacial Surgery, University Hospital of The Ryukyus, Nishihara, Okinawa 903-0215, Japan.
Mol Clin Oncol. 2020 Oct;13(4):36. doi: 10.3892/mco.2020.2106. Epub 2020 Jul 31.
Aortic valve stenosis [or aortic stenosis, (AS)] is a risk factor in non-cardiac surgery. Guidelines from the European Heart Association recommended that AS treatment should be applied prior to non-cardiac surgery. Transcatheter aortic valve implantation (TAVI) is a method of minimally invasive AS treatment. The present study reports a case of tongue excision and neck dissection after TAVI for a patient with tongue cancer and AS. A 79-year-old woman was diagnosed with AS following preoperative examination for tongue cancer. The patient was judged as a high-risk case for open-heart surgery after consultation with staff at the University Hospital of The Ryukyus. It was concluded that TAVI should be performed prior to cancer surgery. On day 21 following TAVI, cancer surgery was performed and the patient was discharged from hospital 22 days after tongue cancer surgery. To the best of our knowledge, there is no report of oral cancer surgery after TAVI. TAVI is generally used as a short-term treatment strategy for AS associated with head and neck cancer due to its minimally invasive nature. In the present case, oral cancer surgery was performed closely following TAVI without serious complications. The case demonstrated that TAVI might be useful for severe AS patients with high surgical risk prior to cancer resection surgery. However, further cases are required to confirm the safety and effectiveness of TAVI treatment strategies.
主动脉瓣狭窄[或主动脉狭窄,(AS)]是非心脏手术的一个风险因素。欧洲心脏协会的指南建议,在进行非心脏手术之前应进行AS治疗。经导管主动脉瓣植入术(TAVI)是一种微创AS治疗方法。本研究报告了1例舌癌合并AS患者在TAVI术后行舌切除术和颈部清扫术的病例。一名79岁女性在接受舌癌术前检查时被诊断为AS。经与琉球大学医院的工作人员会诊,该患者被判定为心脏直视手术的高危病例。结论是应在癌症手术前进行TAVI。TAVI术后第21天进行了癌症手术,患者在舌癌手术后22天出院。据我们所知,尚无TAVI术后口腔癌手术的报道。由于其微创性,TAVI通常被用作与头颈癌相关的AS的短期治疗策略。在本病例中,TAVI术后紧接着进行了口腔癌手术,未出现严重并发症。该病例表明,TAVI可能对癌症切除手术前手术风险高的严重AS患者有用。然而,需要更多病例来证实TAVI治疗策略的安全性和有效性。