Division of Cardiology, Phoenix Children's Center for Heart Care, 1919 East Thomas Road, Phoenix, AZ, 85016, USA.
Division of Anesthesiology, Phoenix Children's Hospital, 1919 E Thomas Road, Phoenix, AZ, 85016, USA.
Pediatr Cardiol. 2023 Oct;44(7):1629-1631. doi: 10.1007/s00246-023-03196-9. Epub 2023 Jun 7.
Complex congenital heart defects may necessitate repeated surgical interventions throughout a patient's lifetime. Each subsequent procedure exposes patients to a greater cumulative risk, thus adding to the potential morbidity and mortality of the surgery. Transcatheter interventions can help mitigate the surgical risk for many defects and can delay or mitigate the need for surgery. This case report describes the rare use of a transapically delivered transcatheter aortic valve replacement (TAVR) therapy in a high-risk pediatric patient to postpone the need for surgery and potentially reduce the number of lifelong surgical interventions. The case highlights how transcatheter aortic valve therapies can be considered for non-standard, higher risk pediatric patients to postpone the need for surgical valve replacement and may serve as a paradigm shift in the care of complex patients with aortic valve pathology.
复杂的先天性心脏缺陷可能需要患者终身接受多次手术干预。每次后续手术都会使患者面临更大的累积风险，从而增加手术的潜在发病率和死亡率。经导管介入治疗可以帮助许多缺陷降低手术风险，并可以延迟或减轻手术的需要。本病例报告描述了一种罕见的经心尖入路的经导管主动脉瓣置换术（TAVR）治疗在高危儿科患者中的应用，以推迟手术的需要，并可能减少终生手术干预的次数。该病例强调了经导管主动脉瓣治疗如何可以考虑用于非标准、高风险的儿科患者，以推迟手术瓣膜置换的需要，并可能成为主动脉瓣病变复杂患者治疗的范式转变。
