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经导管主动脉瓣置换术中对小左冠状动脉窦的冠状动脉保护：一例报告

Coronary protection for the small left coronary sinus during transcatheter aortic valve replacement: a case report.

作者信息

Yang Chen, Song Guangyuan, Niu Guannan, Wu Yongjian

机构信息

Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing 100037, China.

出版信息

Eur Heart J Case Rep. 2022 Jan 24;6(1):ytac011. doi: 10.1093/ehjcr/ytac011. eCollection 2022 Jan.

DOI:10.1093/ehjcr/ytac011
PMID:35243204
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8886909/
Abstract

BACKGROUND

Coronary obstruction (CO) is an infrequent but life-threatening complication during transcatheter aortic valve replacement (TAVR).

CASE SUMMARY

We report the case of a patient who accepted TAVR with high anatomical risks of CO due to the small congenital left coronary sinus, which was treated with preliminary coronary protection. This case highlighted the importance of computed tomography angiography (CTA) evaluation, 3D-printing stimulation, predilation as a reference sign, and pre-emptive chimney stenting technology to successfully anticipate and prevent CO during TAVR. At the 3rd month follow-up, CTA evaluation and 3D-printing simulation identified the chimney stenting of the left main coronary arterial patency.

DISCUSSION

A 'four-step assessment' method also proposes a new clinical procedure on how to perform TAVR in patients with high risks of CO.

摘要

背景

冠状动脉阻塞（CO）是经导管主动脉瓣置换术（TAVR）期间一种罕见但危及生命的并发症。

病例摘要

我们报告了一例患者，因其先天性左冠状动脉窦较小，接受TAVR时发生CO的解剖学风险较高，该患者接受了初步的冠状动脉保护治疗。该病例突出了计算机断层扫描血管造影（CTA）评估、3D打印模拟、预扩张作为参考标志以及抢先式烟囱支架置入技术在TAVR期间成功预测和预防CO的重要性。在第3个月随访时，CTA评估和3D打印模拟确定了左主干冠状动脉通畅的烟囱支架置入情况。

讨论

一种“四步评估”方法还提出了关于如何对具有高CO风险的患者进行TAVR的新临床程序。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/4eb592d5d85e/ytac011f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/18d467382155/ytac011f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/c14ca5e571d2/ytac011f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/ce429a0fde78/ytac011f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/58eb0e767698/ytac011f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/4eb592d5d85e/ytac011f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/18d467382155/ytac011f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/c14ca5e571d2/ytac011f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/ce429a0fde78/ytac011f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/58eb0e767698/ytac011f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15aa/8886909/4eb592d5d85e/ytac011f5.jpg

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