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一名主动脉极度迂曲患者经导管主动脉瓣置换术（TAVR）后保守治疗的胸主动脉穿孔

Thoracic Aorta Perforation Treated Conservatively After TAVR in a Patient With Extremely Tortuous Aorta.

作者信息

Manevich Lisa, Landes Uri, Gluzman Yuri, Welt Michael, Rubinshtein Ronen, Danenberg Haim D

机构信息

Department of Cardiology, E. Wolfson Medical Center, Holon and Tel-Aviv University, Tel-Aviv, Israel.

出版信息

JACC Case Rep. 2022 Nov 29;5:101691. doi: 10.1016/j.jaccas.2022.101691. eCollection 2023 Jan 4.

DOI:10.1016/j.jaccas.2022.101691
PMID:36523949
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9745652/
Abstract

Aortic perforation is a rare complication of transcatheter aortic valve replacement associated with grim outcomes. Tortuous and calcified aortas increase the risk of aortic trauma and perforation. We report a case in which, despite massive thoracic bleeding, avoidance of thoracic aortic surgery resulted in clinical recovery. ().

摘要

主动脉穿孔是经导管主动脉瓣置换术罕见的并发症，预后不佳。迂曲和钙化的主动脉会增加主动脉创伤和穿孔的风险。我们报告一例病例，尽管出现大量胸腔出血，但避免进行胸主动脉手术仍实现了临床康复。（）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/8f31e4d59fd7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/7fd16f8ec335/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/44a1e2edef7f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/e6ffdc277a30/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/8f31e4d59fd7/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/7fd16f8ec335/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/44a1e2edef7f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/e6ffdc277a30/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f072/9745652/8f31e4d59fd7/gr3.jpg

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本文引用的文献

1
Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch.
Can J Cardiol. 2017 Sep;33(9):1206.e1-1206.e3. doi: 10.1016/j.cjca.2017.03.018. Epub 2017 Mar 28.
2
Injuries to the Aorta, Aortic Annulus, and Left Ventricle During Transcatheter Aortic Valve Replacement: Management and Outcomes.经导管主动脉瓣置换术中主动脉、主动脉瓣环和左心室损伤：处理与结果
Circ Cardiovasc Interv. 2017 Jan;10(1). doi: 10.1161/CIRCINTERVENTIONS.116.004735.
3
Perioperative Results and Complications in 15,964 Transcatheter Aortic Valve Replacements: Prospective Data From the GARY Registry.15964 例经导管主动脉瓣置换术的围手术期结果和并发症：来自 GARY 注册研究的前瞻性数据。
J Am Coll Cardiol. 2015 May 26;65(20):2173-80. doi: 10.1016/j.jacc.2015.03.034. Epub 2015 Mar 15.
4
Perforation of the descending thoracic aorta during transcatheter aortic valve implantation (TAVI): an unexpected and dramatic procedural complication.经导管主动脉瓣植入术（TAVI）期间降主动脉穿孔：意想不到的戏剧性手术并发症。
Catheter Cardiovasc Interv. 2011 Jun 1;77(7):1076-8. doi: 10.1002/ccd.22960. Epub 2011 Apr 28.