Wassef Bishoy, Masry Mina, Ghali Mounir, Makaryus John N, Makaryus Amgad N
Department of Sports Medicine, RWJBarnabas Health, Care Station Medical Group, Secaucus, NJ, USA.
Department of Cardiology, Nassau University Medical Center, East Meadow, NY, USA.
Case Rep Radiol. 2022 Feb 16;2022:1366037. doi: 10.1155/2022/1366037. eCollection 2022.
Dynamic imaging of heart valves and specifically prosthetic valves is a central benefit of echocardiography. Most bioprosthetic heart valves degenerate over a given time and hence require repeat valve replacement which carries a significant risk of morbidity and mortality. Reoperation is the standard of care and may still be required after the first successful surgery due to complications disrupting either mechanical or bioprosthetic valves. Such complications can be delayed or even prevented if optimal prosthesis selection is individualized according to patients' medical and postimplantation follow-up. We present the case of an 84-year-old woman where an open-heart valve-in-valve approach, implanting a mechanical valve in a failed bioprosthetic valve, produced a unique image on transthoracic echocardiography which needs to be recognized by imagers for appropriate patient diagnosis and management.
心脏瓣膜尤其是人工心脏瓣膜的动态成像，是超声心动图的一项核心优势。大多数生物人工心脏瓣膜会在一定时间内发生退变，因此需要再次进行瓣膜置换，而这会带来显著的发病和死亡风险。再次手术是治疗的标准方法，并且在首次成功手术后，由于机械瓣膜或生物人工瓣膜出现并发症，仍可能需要再次手术。如果根据患者的病情及植入后的随访情况进行个体化的最佳假体选择，此类并发症可以延迟出现甚至避免。我们报告一例84岁女性患者的病例，该患者采用心脏直视下瓣中瓣手术，在失效的生物人工瓣膜中植入一枚机械瓣膜，经胸超声心动图显示出独特的图像，成像人员需要识别该图像以便对患者进行恰当的诊断和管理。
