Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, USA
Department of Medicine, Division of Cardiology, Ahmanson/UCLA Adult Congenital Cardiology Center, University of California Los Angeles, Los Angeles, California, USA.
BMJ Case Rep. 2023 Aug 16;16(8):e255128. doi: 10.1136/bcr-2023-255128.
Ascites is a condition typically attributed to liver disease but can be cardiac in aetiology as well. We report of an atypical case of pulmonary homograft failure status-post the Ross-Yacoub procedure as an underlying cause of anasarca. A man in his mid-30s with a history of congenital heart disease presented with abdominal distension and exercise intolerance. His prior history was relevant for congenital bicuspid aortic valve with critical aortic stenosis. Abdomen and pelvis CT revealed a grossly dilated inferior vena cava while transthoracic echocardiogram showed severe homograft pulmonary stenosis and regurgitation. Further investigation with cardiac MRI demonstrated severe pulmonary valve stenosis and regurgitation with significant tricuspid regurgitation and right ventricular dilatation. The transcatheter stent in the right ventricular to pulmonary artery conduit followed by transcatheter valve replacement, which resulted in full resolution of his presenting symptoms.
腹水通常归因于肝脏疾病，但也可能与病因相关心脏疾病。我们报告了一例不典型的肺同种异体移植失败病例，该病例是 Ross-Yacoub 手术后心源性全身性水肿的潜在原因。一名 30 多岁的男性，患有先天性心脏病，表现为腹部膨隆和运动耐量下降。他的既往病史与先天性二叶主动脉瓣伴严重主动脉瓣狭窄有关。腹部和骨盆 CT 显示下腔静脉明显扩张，而经胸超声心动图显示严重的同种异体肺狭窄和反流。心脏 MRI 进一步检查显示严重的肺动脉瓣狭窄和反流，伴有显著的三尖瓣反流和右心室扩张。在右心室到肺动脉导管中的经导管支架植入术和随后的经导管瓣膜置换术，使他的症状完全缓解。
