经导管二尖瓣瓣叶植入术治疗不可手术的“大 MAC”。
Open Transcatheter Mitral Valve Implantation Into the Native Mitral Valve for Inoperable "Big MAC".
机构信息
Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.
Department of Cardiology, Medical University Vienna, Vienna, Austria.
出版信息
Tex Heart Inst J. 2022 Nov 1;49(6). doi: 10.14503/THIJ-20-7491.
Abstract
Because of the growing population of older adult patients, the prevalence of severe mitral annulus calcification ("big MAC") is increasing. The surgical techniques used to treat big MACs are technically demanding; despite the technical aspect, up to one-third of patients are considered too high risk for conventional surgery but are candidates for the coulisse technique, which is a procedure that implants a transcatheter valve into a native mitral annulus. The anterior leaflet is unfolded, thus reducing the risk of obstructing the left ventricular outflow tract and for paravalvular leak and avoiding valve migration. Preoperative planning, based on a computed tomography scan, is mandatory.
摘要
由于老年患者人数的增加，严重二尖瓣环钙化（“大 MAC”）的患病率也在增加。用于治疗大 MAC 的手术技术要求很高；尽管存在技术方面的问题，但多达三分之一的患者被认为风险太高，不适合传统手术，但适合 coulisse 技术，该技术是将经导管瓣膜植入原生二尖瓣环的程序。前叶展开，从而降低了阻塞左心室流出道和瓣周漏的风险，并避免了瓣膜迁移。术前规划，基于计算机断层扫描，是强制性的。
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