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吸入一氧化氮成功治疗急诊经导管二尖瓣缘对缘修复术后右心室衰竭:一例报告

Successful Management of Right Ventricular Failure After Emergent Transcatheter Mitral Valve Edge-to-Edge Repair With Inhaled Nitric Oxide: A Case Report.

作者信息

Sato Yuma, Yanagi Akio, Kakumoto Shinichi, Miyawaki Hiroshi

机构信息

Department of Anesthesiology, Kokura Memorial Hospital, Kitakyusyu, JPN.

出版信息

Cureus. 2023 Sep 18;15(9):e45469. doi: 10.7759/cureus.45469. eCollection 2023 Sep.

Abstract

Mitral regurgitation (MR) induces left ventricular failure and pulmonary hypertension (PH) and can lead to right ventricular (RV) failure. Inhaled nitric oxide (iNO) decreases pulmonary vessel resistance. iNO has been used in patients with PH and RV failure. We present a case with cardiogenic shock due to severe degenerative MR. The patient underwent emergent transcatheter mitral valve edge-to-edge repair (TEER). Despite TEER had been successfully performed, hemodynamics did not improve due to RV failure. Administration of iNO improved hemodynamics. This case suggests administration of iNO could be an effective option for RV failure after TEER.

摘要

二尖瓣反流(MR)可导致左心室衰竭和肺动脉高压(PH),并可引发右心室(RV)衰竭。吸入一氧化氮(iNO)可降低肺血管阻力。iNO已用于治疗PH和RV衰竭患者。我们报告一例因严重退行性MR导致心源性休克的病例。该患者接受了紧急经导管二尖瓣缘对缘修复术(TEER)。尽管TEER手术成功完成,但由于RV衰竭,血流动力学并未改善。使用iNO改善了血流动力学。该病例提示,iNO给药可能是TEER术后RV衰竭的有效治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252b/10583858/d3a8112257f9/cureus-0015-00000045469-i01.jpg

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