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从微创到最大程度的侵入性；机械主动脉瓣和二尖瓣情况下的 VT 消融。

From minimally to maximally invasive; VT ablation in the setting of mechanical aortic and mitral valves.

机构信息

Department of Cardiology, Royal Melbourne Hospital, Parkville, Victoria, Australia.

Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Carlton, Victoria, Australia.

出版信息

J Cardiovasc Electrophysiol. 2022 Sep;33(9):2116-2120. doi: 10.1111/jce.15623. Epub 2022 Jul 21.

DOI:10.1111/jce.15623
PMID:35842799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9543159/
Abstract

Double mitral and aortic mechanical valves present an access challenge when planning a ventricular tachycardia (VT) ablation. In this case report, we describe a patient who was considered for stereotactic ablative radiotherapy but was unable to proceed due to unfavorable anatomy making them at high risk of fistula formation. The patient went on to have an endocardial VT ablation via mini-thoracotomy and transapical access without complication. This case highlights the need for careful consideration when planning treatment for patients with double mechanical valves.

摘要

双二尖瓣和主动脉机械瓣在计划室性心动过速 (VT) 消融时会带来通路挑战。在本病例报告中，我们描述了一位患者，由于不利的解剖结构使他们有形成瘘的高风险，因此被考虑接受立体定向消融放疗，但无法进行。该患者随后通过小开胸术和经心尖入路进行了心内膜 VT 消融，无并发症。本病例强调了在为双机械瓣患者制定治疗方案时需要仔细考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/7a224dd0966a/JCE-33-2116-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/138895e6f71a/JCE-33-2116-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/0f228b31eea5/JCE-33-2116-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/7a224dd0966a/JCE-33-2116-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/138895e6f71a/JCE-33-2116-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/0f228b31eea5/JCE-33-2116-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4d0/9543159/7a224dd0966a/JCE-33-2116-g002.jpg

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Cardiac radioablation-A systematic review.
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Phase I/II Trial of Electrophysiology-Guided Noninvasive Cardiac Radioablation for Ventricular Tachycardia.电生理引导的无创性心脏射频消融治疗室性心动过速的 I/II 期试验。
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