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使用直接外置并与右心室节制索交织的概念封堵梗死灶心尖部室间隔缺损：病例系列

Apical post-infarction ventricular septal defect blockage using the direct externalization and enmeshment to the right ventricular moderator band concept: case series.

作者信息

Toledano Bryan Rene F, Rivera Ramon Miguel M, Prado Jose Paolo A, Sabas Michelangelo L, Cheng Dexter Eugene D

机构信息

The Medical City, Cardiovascular Institute, Cardiology Department, Ortigas, Pasig, 1600 Metro Manila, Philippines.

出版信息

Eur Heart J Case Rep. 2023 Aug 2;7(8):ytad376. doi: 10.1093/ehjcr/ytad376. eCollection 2023 Aug.

DOI:10.1093/ehjcr/ytad376
PMID:37575539
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10415859/
Abstract

BACKGROUND

Transcatheter treatment in post-infarction ventricular septal defects can be unique and complex; hence, the development of a new technique is needed to improve outcomes.

SUMMARY

We describe two cases in which large and complex apical post-infarction ventricular septal defects were treated with a novel transcatheter approach as salvage and the other due to refusal for open surgical repair. By direct externalization and enmeshment of a device to the right ventricular moderator band, the defect was blocked and immediate improvement of haemodynamics was achieved.

CONCLUSION

In large, complex, apical post-infarction ventricular septal defects with no apical rims, the DEXTER technique allows for exclusion of the defect and vestigialization of the right ventricular apex. An immediate and dramatic haemodynamic improvement can therefore be achieved.

摘要

背景

心肌梗死后室间隔缺损的经导管治疗可能独特且复杂；因此，需要开发新技术以改善治疗效果。

总结

我们描述了两例大型复杂的心尖部心肌梗死后室间隔缺损病例，其中一例采用新型经导管方法作为挽救性治疗，另一例是由于患者拒绝接受开胸手术修复。通过将装置直接外置并固定于右心室节制束，封堵了缺损并立即改善了血流动力学。

结论

对于没有心尖边缘的大型、复杂的心尖部心肌梗死后室间隔缺损，DEXTER技术可封堵缺损并使右心室心尖部退化。因此可立即显著改善血流动力学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/df12d59ca27f/ytad376f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/74b642dcc876/ytad376f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/8dcd5a09834a/ytad376f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/b7cdc7cf0034/ytad376f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/793e918f3010/ytad376f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/d24f53325e5b/ytad376f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/41e1d1ac50ad/ytad376f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/df12d59ca27f/ytad376f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/74b642dcc876/ytad376f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/8dcd5a09834a/ytad376f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/b7cdc7cf0034/ytad376f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/793e918f3010/ytad376f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/d24f53325e5b/ytad376f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/41e1d1ac50ad/ytad376f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b47/10415859/df12d59ca27f/ytad376f7.jpg

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