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一名孕妇的重度瓣下主动脉狭窄

Severe Subvalvular Aortic Stenosis in a Pregnant Woman.

作者信息

Elyas Ahmed Abdalla, Al Maghraby Ahmed Mohamed

机构信息

Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

Heart Views. 2022 Jan-Mar;23(1):60-66. doi: 10.4103/heartviews.heartviews_26_22. Epub 2022 May 16.

DOI:10.4103/heartviews.heartviews_26_22
PMID:35757451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9231546/
Abstract

A 35-year-old pregnant female in her second trimester presented with heart failure manifestations with evidence of very severe fixed left ventricular outflow tract obstruction. The peak systolic gradient was 132 mmHg, which is the highest reported in the literature, secondary to congenital subaortic membrane. Similar case reports that we could find in the literature were reviewed to highlight the importance of such anomaly.

摘要

一名35岁处于孕中期的孕妇出现心力衰竭表现，并有非常严重的固定性左心室流出道梗阻的证据。收缩期峰值梯度为132毫米汞柱，这是文献报道中最高的，病因是先天性主动脉瓣下隔膜。我们查阅了文献中能找到的类似病例报告，以强调这种异常情况的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/4fbad3f47480/HV-23-60-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/45c9fa158d59/HV-23-60-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/c78cb13aa0b0/HV-23-60-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/4fbad3f47480/HV-23-60-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/45c9fa158d59/HV-23-60-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/c78cb13aa0b0/HV-23-60-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3053/9231546/4fbad3f47480/HV-23-60-g003.jpg

相似文献

1
Severe Subvalvular Aortic Stenosis in a Pregnant Woman.一名孕妇的重度瓣下主动脉狭窄
Heart Views. 2022 Jan-Mar;23(1):60-66. doi: 10.4103/heartviews.heartviews_26_22. Epub 2022 May 16.
2
Treatment of severe valvular aortic stenosis and subvalvular discrete subaortic stenosis and septal hypertrophy with Percutaneous CoreValve Aortic Valve Implantation.经皮主动脉瓣置入术治疗严重主动脉瓣狭窄和瓣下离散型主动脉瓣下狭窄合并间隔肥厚。
Catheter Cardiovasc Interv. 2010 Apr 1;75(5):801-3. doi: 10.1002/ccd.22318.
3
Morphology of left ventricular outflow tract structures in patients with subaortic stenosis and a ventricular septal defect.主动脉瓣下狭窄合并室间隔缺损患者左心室流出道结构的形态学
Br Heart J. 1994 Sep;72(3):251-60. doi: 10.1136/hrt.72.3.251.
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Dual-Chamber pacing for postoperative residual left ventricular gradient after aortic valve replacement and concomitant septal myectomy for severe aortic stenosis and subvalvular obstruction.双腔起搏用于主动脉瓣置换术后残余左心室梯度及重度主动脉瓣狭窄和瓣下梗阻的同期室间隔心肌切除术。
J Cardiol Cases. 2020 May 1;22(1):15-18. doi: 10.1016/j.jccase.2020.03.011. eCollection 2020 Jul.
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Subvalvular Aortic Stenosis.瓣下主动脉瓣狭窄
Del Med J. 2015 Nov;87(11):346-8.
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[Obstruction of the left ventricular outflow tract due to an anomalous muscle bundle and an accessory tissue on the mitral valve associated with mitral stenosis].[因异常肌束和二尖瓣上的附属组织导致左心室流出道梗阻并伴有二尖瓣狭窄]
Nihon Kyobu Geka Gakkai Zasshi. 1994 Apr;42(4):622-8.
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Coexisting right and left hypertrophic subvalvular stenosis and fixed left ventricular outflow obstruction due to aortic valve stenosis.
Am J Cardiol. 1977 Jul;40(1):133-6. doi: 10.1016/0002-9149(77)90111-4.
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[Obstruction of the left ventricular outflow tract caused by bicuspid aortic valve and discrete subaortic membrane].[二叶式主动脉瓣和局限性主动脉瓣下隔膜导致的左心室流出道梗阻]
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Subaortic Stenosis With Elevated Aortic Gradients in a Pregnant Patient.一名孕妇出现主动脉梯度升高的主动脉瓣下狭窄
JACC Case Rep. 2020 Jan 15;2(1):131-134. doi: 10.1016/j.jaccas.2019.11.054. eCollection 2020 Jan.

本文引用的文献

1
Pregnancy related changes in Doppler gradients and left ventricular mechanics in women with sub-valvular or valvular aortic stenosis.妊娠对瓣下或瓣膜性主动脉瓣狭窄女性的多普勒梯度和左心室力学的影响。
Echocardiography. 2021 Oct;38(10):1754-1761. doi: 10.1111/echo.15208. Epub 2021 Oct 21.
2
Subaortic Stenosis With Elevated Aortic Gradients in a Pregnant Patient.一名孕妇出现主动脉梯度升高的主动脉瓣下狭窄
JACC Case Rep. 2020 Jan 15;2(1):131-134. doi: 10.1016/j.jaccas.2019.11.054. eCollection 2020 Jan.
3
Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis.
主动脉-腔静脉压迫导致下主动脉瓣狭窄患者剖宫产术中突然意识丧失、严重心动过缓和低血压。
BMC Anesthesiol. 2019 Jul 4;19(1):116. doi: 10.1186/s12871-019-0791-x.
4
2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy.2018年欧洲心脏病学会妊娠期心血管疾病管理指南。
Eur Heart J. 2018 Sep 7;39(34):3165-3241. doi: 10.1093/eurheartj/ehy340.
5
Heart Failure Caused by Misdiagnosed Subaortic Stenosis in Adulthood: Lesson for Daily Practice.成人主动脉瓣下狭窄误诊导致的心衰：日常实践的教训
Ann Thorac Surg. 2017 Jul;104(1):e91. doi: 10.1016/j.athoracsur.2017.01.122.
6
Risk of Pregnancy in Moderate and Severe Aortic Stenosis: From the Multinational ROPAC Registry.中重度主动脉瓣狭窄患者的妊娠风险：来自多国 ROPAC 注册研究。
J Am Coll Cardiol. 2016 Oct 18;68(16):1727-1737. doi: 10.1016/j.jacc.2016.07.750.
7
Continuous spinal labor analgesia for two deliveries in a parturient with severe subvalvular aortic stenosis.
J Anesth. 2016 Dec;30(6):1067-1070. doi: 10.1007/s00540-016-2238-6. Epub 2016 Aug 22.
8
Congenital discrete subaortic stenosis in pregnancy: case report and literature review.孕期先天性孤立性主动脉瓣下狭窄：病例报告及文献综述
J Heart Valve Dis. 2013 May;22(3):439-44.
9
A successful pregnancy outcome following the Ross procedure: a case report.罗斯手术（Ross procedure）后成功的妊娠结局：一例病例报告。
Am J Perinatol. 2009 Apr;26(4):287-9. doi: 10.1055/s-0028-1103157. Epub 2008 Dec 8.
10
ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.美国心脏病学会/美国心脏协会2008年成人先天性心脏病管理指南：美国心脏病学会/美国心脏协会实践指南工作组（制定成人先天性心脏病管理指南写作委员会）报告。与美国超声心动图学会、心律学会、国际成人先天性心脏病学会、心血管造影和介入学会以及胸外科医师学会合作制定。
J Am Coll Cardiol. 2008 Dec 2;52(23):e143-e263. doi: 10.1016/j.jacc.2008.10.001.