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法洛四联症心内修复术后年轻患者同期主动脉瓣和肺动脉瓣置换:机械瓣还是生物瓣?一例报告

Simultaneous aortic and pulmonary valve replacement in a young patient after intracardiac repair for tetralogy of Fallot: mechanical or biological valve? A case report.

作者信息

Okubo Ryo, Kimura Fumiaki, Harada Hideyuki, Kobayashi Daita, Shirasaka Tomonori, Kamiya Hiroyuki

机构信息

Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.

Department of Cardiovascular Surgery, Kushiro Kojinkai Memorial Hospital, Kushiro, Japan.

出版信息

J Surg Case Rep. 2021 May 17;2021(5):rjab170. doi: 10.1093/jscr/rjab170. eCollection 2021 May.

Abstract

Pulmonary valve stenosis and regurgitation can occur in the distant stages after intracardiac repair of tetralogy of Fallot (TOF). Aortic regurgitation (AR) can also occur, although it is rare in postoperative patients. However, there are few reports of simultaneous replacement of the pulmonary and aortic valves in young patients after intracardiac repair of TOF, and there are no clear guidelines for selecting a valve prosthesis in such patients. We report a case of severe pulmonary valve stenosis and regurgitation with severe AR 38 years after the TOF operation, in which urgent double valve replacement and right ventricular outflow tract patching were performed with a mechanical valve in the aortic valve position and a bioprosthetic valve in the pulmonary valve position, with a successful outcome.

摘要

法洛四联症(TOF)心内修复术后远期可出现肺动脉瓣狭窄和反流。主动脉瓣反流(AR)也可能发生,尽管在术后患者中较为罕见。然而,关于TOF心内修复术后年轻患者同时置换肺动脉瓣和主动脉瓣的报道很少,且此类患者选择瓣膜假体尚无明确指南。我们报告1例TOF手术后38年出现严重肺动脉瓣狭窄和反流合并严重AR的病例,该病例紧急进行了双瓣膜置换,并在主动脉瓣位置植入机械瓣膜,在肺动脉瓣位置植入生物瓣膜进行右心室流出道修补,结果成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a5c/8130639/86b599dfd2f4/rjab170f1.jpg

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