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Open Transcatheter Mitral Valve Implantation Into the Native Mitral Valve for Inoperable "Big MAC".经导管二尖瓣瓣叶植入术治疗不可手术的“大 MAC”。
Tex Heart Inst J. 2022 Nov 1;49(6). doi: 10.14503/THIJ-20-7491.
2
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3
Long or redundant leaflet complicating transcatheter mitral valve replacement: Case vignettes that advocate for removal or reduction of the anterior mitral leaflet.长或冗余的瓣叶使经导管二尖瓣置换复杂化：提倡切除或减少二尖瓣前叶的病例。
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Balloon assisted translocation of the mitral anterior leaflet to prevent left ventricular outflow obstruction (BATMAN): A novel technique for patients undergoing transcatheter mitral valve replacement.球囊辅助二尖瓣前叶转位术预防左心室流出道梗阻（BATMAN）：经导管二尖瓣置换术患者的一种新方法。
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Circ Cardiovasc Interv. 2018 Oct;11(10):e006412. doi: 10.1161/CIRCINTERVENTIONS.118.006412.

本文引用的文献

1
Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings.经导管二尖瓣置换术治疗退行性生物瓣及瓣环成形环失败
J Am Coll Cardiol. 2017 Aug 29;70(9):1121-1131. doi: 10.1016/j.jacc.2017.07.714.
2
Severe Mitral Annular Calcification: Multimodality Imaging for Therapeutic Strategies and Interventions.严重二尖瓣环钙化：治疗策略和干预的多模态影像学。
JACC Cardiovasc Imaging. 2016 Nov;9(11):1318-1337. doi: 10.1016/j.jcmg.2016.09.001.
3
Transcatheter Mitral Valve Replacement in Native Mitral Valve Disease With Severe Mitral Annular Calcification: Results From the First Multicenter Global Registry.经导管二尖瓣置换术治疗伴严重二尖瓣瓣环钙化的原发性二尖瓣疾病：首个多中心全球注册研究结果。
JACC Cardiovasc Interv. 2016 Jul 11;9(13):1361-71. doi: 10.1016/j.jcin.2016.04.022.
4
Transcatheter mitral valve implantation for inoperable severely calcified native mitral valve disease: A systematic review.经导管二尖瓣植入术治疗无法手术的严重钙化原发性二尖瓣疾病：一项系统评价
Catheter Cardiovasc Interv. 2016 Feb 15;87(3):540-8. doi: 10.1002/ccd.26262. Epub 2015 Nov 18.
5
The mitral annular stone: a surgical challenge.二尖瓣环结石：一项手术挑战。
Eur J Cardiothorac Surg. 2015 Nov;48(5):805. doi: 10.1093/ejcts/ezv030. Epub 2015 Feb 13.
6
Pushing the limits-further evolutions of transcatheter valve procedures in the mitral position, including valve-in-valve, valve-in-ring, and valve-in-native-ring.经导管二尖瓣置换术的极限拓展，包括瓣中瓣、瓣环中瓣和瓣环内瓣。
J Thorac Cardiovasc Surg. 2014 Jan;147(1):210-9. doi: 10.1016/j.jtcvs.2013.09.021. Epub 2013 Oct 30.
7
A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease.欧洲心脏瓣膜病患者前瞻性调查：欧洲心脏瓣膜病调查
Eur Heart J. 2003 Jul;24(13):1231-43. doi: 10.1016/s0195-668x(03)00201-x.
8
Use of the anterior mitral leaflet to reinforce the posterior mitral annulus after debridement of calcium.在清除钙化后使用二尖瓣前叶来加强二尖瓣后瓣环。
Ann Thorac Surg. 1999 Jul;68(1):261-2. doi: 10.1016/s0003-4975(99)00337-9.
9
Extensive calcification of the mitral valve anulus: pathology and surgical management.二尖瓣瓣环广泛钙化：病理学与外科治疗
J Thorac Cardiovasc Surg. 1996 Apr;111(4):718-29; discussion 729-30. doi: 10.1016/s0022-5223(96)70332-x.

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.

DOI:10.14503/THIJ-20-7491
PMID:36520106
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9809100/
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。