二尖瓣成形环裂开致严重二尖瓣反流的二尖瓣环内修复术成功：一例报告
Successful mitral valve-in-ring repair of mitral annuloplasty ring dehiscence causing severe mitral regurgitation: a case report.
作者信息
Sharma Harish, Nadir M Adnan, Steeds Richard P, Doshi Sagar N
机构信息
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
Department of Cardiology, University Hospitals Birmingham, Birmingham, B15 2TH, UK.
出版信息
Eur Heart J Case Rep. 2021 Oct 26;5(11):ytab433. doi: 10.1093/ehjcr/ytab433. eCollection 2021 Nov.
BACKGROUND
Annuloplasty failure caused by ring dehiscence can lead to trans-ring and para-ring mitral regurgitation (MR). Transcatheter treatments are available for patients at prohibitive risk of surgery. In patients unsuitable for edge-to-edge repair, valve-in-ring (ViR) transcatheter mitral valve (MV) implantation has been described to treat trans-ring or para-ring jets but not both concurrently.
CASE SUMMARY
A 78-year-old male presented with severe MR due to dehiscence of a 34 mm Edwards Physio II mitral annuloplasty ring. Transoesophageal echocardiography showed two jets of regurgitation; trans-ring and para-ring. Repair was successfully undertaken with a ViR procedure (29 mm S3 Edwards Lifesciences).
DISCUSSION
Patients with failure of MV annuloplasty with trans-ring and para-ring regurgitation can be safely and effectively treated by ViR transcatheter MV implantation.
背景
瓣环裂开导致的瓣环成形术失败可引起经瓣环和瓣环旁二尖瓣反流（MR）。对于手术风险极高的患者，可采用经导管治疗。对于不适合边缘对边缘修复的患者，已描述采用瓣中瓣（ViR）经导管二尖瓣（MV）植入术来治疗经瓣环或瓣环旁反流束，但不能同时治疗两者。
病例摘要
一名78岁男性因34毫米爱德华兹Physio II二尖瓣瓣环成形环裂开出现严重MR。经食管超声心动图显示有两股反流束；经瓣环和瓣环旁反流束。采用ViR手术（29毫米S3爱德华兹生命科学公司产品）成功完成修复。
讨论
对于二尖瓣瓣环成形术失败且伴有经瓣环和瓣环旁反流的患者，ViR经导管MV植入术可安全有效地进行治疗。
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