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标准外科主动脉瓣植入术导致的严重二尖瓣关闭不全及其无缝线假体修复。

Severe mitral valve insufficiency caused by standard surgical aortic valve implantation and its reparation using suture-less prosthesis.

机构信息

Cardiac surgery department of Faculty Hospital in Pilsen, Charles University in Prague, Alej Svobody 80, 304 60, Pilsen, Czech Republic.

Department of Physiology, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 1655/76, 323 00, Pilsen, Czech Republic.

出版信息

J Cardiothorac Surg. 2022 Jun 18;17(1):159. doi: 10.1186/s13019-022-01896-6.

Abstract

BACKGROUND

Aortic valve stenosis is the most frequent cardiac valve pathology in the western world. Surgical aortic valve replacement is the gold standard for the treatment of significant degenerative aortic valve diseases.

CASE PRESENTATION

This case report highlights an unexpected abnormal iatrogenic shortening of the aorto-mitral continuity and its deformity, during traditional AVR using sutured stented aortic prosthesis as the first choice, which caused significant mitral valve regurgitation. The suture-less prosthesis was a rescue choice to restore the geometry and eliminate the deformation of the aorto-mitral continuity.

CONCLUSIONS

Aortic valve replacement using suture-less prosthesis could be a valuable optional choice for lowering the risk of deformation of the aortic annulus and aorto-mitral continuity. It might provide better outcomes in combined procedures.

摘要

背景

主动脉瓣狭窄是西方世界最常见的心脏瓣膜病。外科主动脉瓣置换术是治疗严重退行性主动脉瓣疾病的金标准。

病例介绍

本病例报告强调了在首选缝合支架主动脉假体进行传统 AVR 期间,出现意料之外的异常医源性缩短和变形的主动脉-二尖瓣连续性,这导致了严重的二尖瓣反流。无缝合假体是一种挽救选择,可恢复主动脉-二尖瓣连续性的几何形状并消除变形。

结论

使用无缝合假体进行主动脉瓣置换术可能是降低主动脉瓣环和主动脉-二尖瓣连续性变形风险的有价值的可选方案。它可能在联合手术中提供更好的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64c9/9206334/e6314c13ef9a/13019_2022_1896_Fig1_HTML.jpg

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