Medda Massimo, Casilli Francesco, Bande Marta, Tespili Maurizio, Donatelli Francesco
Clinical and Interventional Cardiology Unit, Cardio-Thoracic Center, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Gruppo San Donato, Milan, Italy.
Clinical and Interventional Cardiology Unit, Cardio-Thoracic Center, Istituto Clinico Sant'Ambrogio, Gruppo San Donato, Milan, Italy.
Front Cardiovasc Med. 2023 Sep 15;10:1195486. doi: 10.3389/fcvm.2023.1195486. eCollection 2023.
Transcatheter aortic valve replacement (TAVR) is a treatment of choice in patients with symptomatic severe aortic valve stenosis (AS) and intermediate-to-high surgical risk. The presence of a small aortic annulus (SAA) has been associated with a higher incidence of prosthesis-patient mismatch (PPM) when surgical aortic valve replacement (sAVR) is performed. TAVR might be a treatment option offering better hemodynamics with a lower incidence of PPM. When a severe AS with a SAA is treated, TAVR-related risk as the coronary obstruction and the annulus rupture, must be also prevented. We present a case of a TAVR in a very small aortic annulus; to our knowledge, this is the smallest native aortic annulus treated percutaneously in a tricuspid stenotic aortic valve with a Self-Expanding Transcatheter Heart Valve (THV) Acurate Neo 2.
经导管主动脉瓣置换术（TAVR）是有症状的严重主动脉瓣狭窄（AS）且手术风险为中到高的患者的首选治疗方法。当进行外科主动脉瓣置换术（sAVR）时，小主动脉瓣环（SAA）的存在与人工瓣膜-患者不匹配（PPM）的较高发生率相关。TAVR可能是一种能提供更好血流动力学且PPM发生率较低的治疗选择。当治疗伴有SAA的严重AS时，还必须预防与TAVR相关的风险，如冠状动脉阻塞和瓣环破裂。我们报告一例在非常小的主动脉瓣环中进行TAVR的病例；据我们所知，这是使用自膨胀经导管心脏瓣膜（THV）Acurate Neo 2经皮治疗的最小的三尖瓣狭窄主动脉瓣的天然主动脉瓣环。
