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经皮二尖瓣夹合术器械罕见迁移至左心室心尖部。

The rare case of a MitraClip device migrating into the left ventricular apex.

机构信息

Department of Cardiovascular Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate Prefecture, 028-3695, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2021 Aug;69(8):1267-1270. doi: 10.1007/s11748-021-01624-2. Epub 2021 Mar 26.

Abstract

A 79-year-old man with atrial fibrillation and heart failure due to grade 4 + mitral valve regurgitation after coronary artery bypass underwent the MitraClip procedure using two clips. Three days after the procedure, chest radiographs indicated migration of one of the two clips into the left ventricle. He suffered from 3 + recurrent mitral regurgitation, tricuspid valve regurgitation. The echocardiogram and computed tomography scans indicated migration of the clip into the left ventricular apex; he underwent mitral valve replacement, removal of the migrated clip to prevent embolism, left atrial appendage closure, and tricuspid valve ring-annuloplasty. In the postoperative acute phase, embolism by detached and lost MitraClip device is possible, which can be difficult to remove.

摘要

一位 79 岁男性,因冠状动脉旁路移植术后 4+级二尖瓣反流导致心房颤动和心力衰竭,接受了二尖瓣夹合术,使用了两个夹子。手术后 3 天,胸部 X 光片显示其中一个夹子迁移到了左心室。他患有 3+级复发性二尖瓣反流、三尖瓣反流。超声心动图和计算机断层扫描显示夹子迁移到左心室心尖;他接受了二尖瓣置换术、迁移夹子的移除以防止栓塞、左心耳闭合术和三尖瓣环成形术。在术后急性期,可能会发生脱落和丢失的 MitraClip 装置栓塞,且难以移除。

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