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室间隔缺损成功闭合:经导管主动脉瓣置换术后的一种罕见并发症。

Successful closure of the ventricular septal defect;A rare complication after transcatheter aortic valve replacement.

作者信息

Demirtas Inci Saadet, Tulmaç Murat, Tunca Cagatay, Efe Tolgahan, Güllü Hakan

机构信息

Health Sciences University Yildirim Beyazit Diskapi Education And Research Hospital, Cardiology Department, Ankara, Turkey.

出版信息

J Cardiovasc Thorac Res. 2022;14(3):208-211. doi: 10.34172/jcvtr.2022.27. Epub 2022 Sep 10.

Abstract

In this report, we present a patient with ventricular septal defect (VSD) that was detected at follow-up one month after transcatheter aortic valve implantation (TAVI) and successfully closed percutaneously. Before the procedure, a 29 mm Portico self-expanding aortic valve prosthesis was placed in the heavy calcific aortic valve position, and then the balloon was dilated due to aortic insufficiency and excellent results were obtained. One month after TAVI, the patient complained of shortness of breath at rest, and on physical examination a pansystolic murmur was detected. Transthoracic echocardiography (TTE) revealed a well-functioning prosthetic aortic valve; however, a VSD was detected causing left-to-right shunt in the interventricular septum. Later, we performed the interventional treatment of the defect using the Amplatzer muscular VSD occluder device with the transfemoral approach. Currently, five months after the combined procedure, the patient showed a significant improvement in symptoms and no significant shunt was observed.

摘要

在本报告中,我们介绍了一名患有室间隔缺损(VSD)的患者,该缺损在经导管主动脉瓣植入术(TAVI)后1个月的随访中被发现,并通过经皮方式成功闭合。在手术前,将一个29毫米的Portico自膨胀主动脉瓣假体置于重度钙化的主动脉瓣位置,然后因主动脉瓣关闭不全对球囊进行扩张,取得了良好效果。TAVI术后1个月,患者主诉静息时气短,体格检查发现全收缩期杂音。经胸超声心动图(TTE)显示人工主动脉瓣功能良好;然而,发现室间隔存在VSD导致左向右分流。后来,我们采用经股动脉途径,使用Amplatzer肌部VSD封堵器对缺损进行了介入治疗。目前,联合手术后5个月,患者症状有显著改善,未观察到明显分流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53b4/9617057/1b5c02b9b801/jcvtr-14-208-g001.jpg

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