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使用SAPIEN-S3瓣膜经皮植入肺动脉瓣时，功能失调的原生右心室流出道带来的独特挑战。

Unique challenges posed by a dysfunctional native right ventricular outflow tract for percutaneous pulmonary valve implantation using SAPIEN-S3 valve.

作者信息

Sivakumar Kothandam, Chandrasekaran Ramyashri, Hijazi Ziyad M

机构信息

Department of Pediatric Cardiology, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India.

Sidra Heart Center, Sidra Medicine and Weill Cornell Medical College, Doha, Qatar.

出版信息

Ann Pediatr Cardiol. 2022 Mar-Apr;15(2):175-179. doi: 10.4103/apc.apc_86_21. Epub 2022 Aug 19.

DOI:10.4103/apc.apc_86_21
PMID:36246747
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9564412/
Abstract

Dysfunctional right ventricular outflow tracts after a repair for tetralogy of Fallot using a transannular patch offer limited nonsurgical opportunities due to their large dimensions. A discrete subannular narrowing between a dilated right ventricle and the enlarged pulmonary trunk was a potential anatomical target for the creation of a landing zone using a prestent in a young male with severe pulmonary regurgitation and moderate stenosis. Asymmetric expansion of the prestent in the angulated outflow tract led to distal stent embolization that was stabilized by another telescoping stent before successful valve implantation. This manuscript details the unique challenges posed by a dilated regurgitant outflow tract for implanting a pulmonary valve.

摘要

法洛四联症经跨环补片修复术后，右心室流出道功能异常，因其尺寸较大，非手术治疗机会有限。在一名患有严重肺动脉反流和中度狭窄的年轻男性中，扩张的右心室与扩大的肺动脉干之间的离散性瓣下狭窄是使用预扩张支架创建着陆区的潜在解剖靶点。预扩张支架在成角的流出道中不对称扩张，导致远端支架栓塞，在成功植入瓣膜之前，通过另一个套叠式支架使其稳定。本文详细介绍了扩张性反流流出道在植入肺动脉瓣时所带来的独特挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/694e89165422/APC-15-175-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/7714bf0b46e7/APC-15-175-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/8b7204e407c3/APC-15-175-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/0dd2cfebb8fd/APC-15-175-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/f55ac6b4a67e/APC-15-175-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/6477f20a303b/APC-15-175-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/694e89165422/APC-15-175-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/7714bf0b46e7/APC-15-175-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/8b7204e407c3/APC-15-175-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/0dd2cfebb8fd/APC-15-175-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/f55ac6b4a67e/APC-15-175-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/6477f20a303b/APC-15-175-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/561e/9564412/694e89165422/APC-15-175-g006.jpg

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本文引用的文献

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J Thorac Dis. 2020 Nov;12(11):6422-6425. doi: 10.21037/jtd-20-1621.
2
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Arch Cardiovasc Dis. 2020 Feb;113(2):113-120. doi: 10.1016/j.acvd.2019.12.004. Epub 2020 Feb 18.
3
The Sapien valve provides enough grip to be implanted in pulmonary position without a pre-stent.
Sapien瓣膜具有足够的抓握力，无需预支架即可植入肺动脉位置。
Cardiovasc Diagn Ther. 2019 Oct;9(Suppl 2):S264-S268. doi: 10.21037/cdt.2019.09.08.
4
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Cardiol Young. 2019 Jul;29(7):972-976. doi: 10.1017/S1047951119001264. Epub 2019 Jun 20.
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