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病例报告:使用新型球囊扩张式主动脉瓣经导管三尖瓣瓣中瓣植入术及1年随访

Case report: Transcatheter tricuspid valve-in-valve implantation using novel balloon-expandable aortic valve with 1 year follow-up.

作者信息

Mussayev Abdurashid, Alimbayev Serik, Tanaliev Nursultan, Kuanyshbek Aidyn, Marat Aripov, Lesbekov Timur, Raissov Yerkezhan, Sadykova Aigerim, Kamila Askarovna Kenzhebayeva, Mukarov Murat, Pya Yuriy

机构信息

Head of Cathlab, National Research Cardiac Surgery Center, Astana, Kazakhstan.

Head of Structural Heart Diseases, National Research Cardiac Surgery Center, Astana, Kazakhstan.

出版信息

Front Cardiovasc Med. 2023 Jul 4;10:1152280. doi: 10.3389/fcvm.2023.1152280. eCollection 2023.

Abstract

Generally, the dysfunction or failure of bioprosthetic heart valves (BHVs) is managed by replacement surgery. In the case of tricuspid valve dysfunction, re-do surgery is rarely attempted because of the critically high risk of developing pulmonary hypertension, pulmonary embolism, and intraoperative mortality. Hence, transcatheter tricuspid repair and replacement procedures are preferred. More recently, transcatheter valve-in-valve (ViV) treatments have gained importance because of their less invasiveness, especially for patients with prior surgeries. Encouraging evidence of the safety and effectiveness of a novel balloon-expandable (BE) transcatheter heart valve (THV)-the Myval THV-has been reported for ViV procedures. Here, we present a case-series of 5 patients, in whom tricuspid ViV procedure was performed using BE Myval THV, implanted supra-annularly by anchoring onto the deteriorated BHV. This case-series details the procedural steps to prevent in-hospital adverse events and early (30-day) mortality and the challenges during tricuspid ViV interventions.

摘要

一般来说,生物人工心脏瓣膜(BHVs)功能障碍或衰竭通过置换手术来处理。对于三尖瓣功能障碍的情况,由于发生肺动脉高压、肺栓塞和术中死亡率的风险极高,很少尝试再次手术。因此,经导管三尖瓣修复和置换手术更受青睐。最近,经导管瓣中瓣(ViV)治疗因其侵入性较小而变得重要,特别是对于有过手术史的患者。一种新型球囊扩张式(BE)经导管心脏瓣膜(THV)——Myval THV用于ViV手术的安全性和有效性已有令人鼓舞的证据报道。在此,我们展示了一个包含5例患者的病例系列,这些患者接受了使用BE Myval THV进行的三尖瓣ViV手术,通过锚定在恶化的BHV上在瓣环上方植入。该病例系列详细介绍了预防院内不良事件和早期(30天)死亡率的手术步骤以及三尖瓣ViV干预过程中的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f937/10361752/64f3d3a0f4ae/fcvm-10-1152280-g001.jpg

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