Ancona Marco B, Moroni Francesco, Romano Vittorio, Agricola Eustachio, Esposito Antonio, Ajello Silvia, De Bonis Michele, Cappelletti Alberto M, Zangrillo Alberto, Scandroglio Anna Mara, Montorfano Matteo
Emodinamica e Cardiologia Interventistica, IRCCS Ospedale San Raffaele, Milano.
Laboratorio di Ecocardiografia, IRCCS Ospedale San Raffaele, Milano - Università Vita-Salute San Raffaele, Milano.
G Ital Cardiol (Rome). 2021 Mar;22(3 Suppl 1):39S-42S. doi: 10.1714/3578.35633.
Aortic valve regurgitation is a not negligible complication of prolonged support with continuous-flow left ventricular assist device (LVAD) and is associated with recurrence of heart failure and reduced survival. Transcatheter aortic valve implantation has been described as a feasible option in this setting, usually with self-expanding prosthesis. Giving the absence of valvular calcification, a proper prosthesis oversizing should be guaranteed in order to achieve sufficient sealing and avoid prosthesis migration or paravalvular leak. Current self-expanding prosthesis may be too small to fit aortic annulus anatomies without calcification and with the need of significant oversize. We report the first case of 32 mm balloon expandable Myval prosthesis implantation in a patient with LVAD-related aortic regurgitation. Large balloon-expandable prosthesis can be considered when a significant oversize is needed.
主动脉瓣反流是持续血流左心室辅助装置（LVAD）长期支持治疗不可忽视的并发症，与心力衰竭复发及生存率降低相关。经导管主动脉瓣植入术在这种情况下已被描述为一种可行的选择，通常使用自膨胀式假体。鉴于不存在瓣膜钙化，应确保适当的假体尺寸过大，以实现充分密封并避免假体移位或瓣周漏。目前的自膨胀式假体可能过小，无法适配无钙化且需要显著过大尺寸的主动脉瓣环解剖结构。我们报告了首例在与LVAD相关的主动脉反流患者中植入32毫米球囊扩张式Myval假体的病例。当需要显著过大尺寸时，可考虑使用大型球囊扩张式假体。
