Morita Shohei, Takahashi Shinya, Pernot Mathieu, Leroux Lionel, Labrousse Louis
Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Medico-Surgical Department of Valvulopathies, University Hospital of Bordeaux, Bordeaux, France.
J Cardiol Cases. 2020 Jul 18;22(5):207-209. doi: 10.1016/j.jccase.2020.06.017. eCollection 2020 Nov.
Mitral valve replacement (MVR) using a prosthesis of transcatheter aortic valve implantation for mitral annular calcification (MAC) is an alternative procedure which is very different from a conventional MVR and is safe. Acceptable results including mortality and morbidity have been reported. We report the case of a male patient treated with this procedure. There was a risk of left ventricular rupture due to extensive decalcification, so we performed transcatheter mitral valve implantation (TMVI). Since he had a history of surgical aortic valve replacement (AVR), we chose open-heart transseptal approach so as not to interfere with the aortic prosthesis. TMVI has a risk of an iatrogenic left ventricular outflow tract (LVOT) obstruction. Using open-heart transseptal approach, we could easily check an anterior commissure of mitral annulus to prevent LVOT obstruction. < Transcatheter mitral valve implantation (TMVI) using a transcatheter aortic prosthesis is safe for mitral valve disease with mitral annular calcifications. This patient had a history of surgical aortic valve replacement, so we performed open-heart transseptal TMVI to prevent interference with the aortic prosthesis and the iatrogenic left ventricular outflow tract obstruction.>.
使用经导管主动脉瓣植入假体进行二尖瓣置换术（MVR）治疗二尖瓣环钙化（MAC）是一种与传统MVR截然不同的替代手术，且安全可行。已有关于包括死亡率和发病率在内的可接受结果的报道。我们报告了一名接受该手术治疗的男性患者的病例。由于广泛脱钙存在左心室破裂风险，因此我们进行了经导管二尖瓣植入术（TMVI）。鉴于他有外科主动脉瓣置换术（AVR）病史，我们选择了心脏直视经房间隔入路，以免干扰主动脉假体。TMVI存在医源性左心室流出道（LVOT）梗阻风险。采用心脏直视经房间隔入路，我们能够轻松检查二尖瓣环前联合以预防LVOT梗阻。<使用经导管主动脉假体进行经导管二尖瓣植入术（TMVI）对于患有二尖瓣环钙化的二尖瓣疾病是安全的。该患者有外科主动脉瓣置换病史，因此我们进行了心脏直视经房间隔TMVI以防止干扰主动脉假体和医源性左心室流出道梗阻。>
