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通过一期经导管主动脉瓣置换术和经导管缘对缘修复术同时处理主动脉瓣和二尖瓣反流:病例报告

Simultaneous management of aortic and mitral regurgitation through one-stage transcatheter aortic valve replacement and transcatheter edge-to-edge repair: case report.

作者信息

Lin Hao, Zhu Mei, Lv Meng, Wang Zhengjun

机构信息

Department of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

出版信息

Front Cardiovasc Med. 2024 Feb 27;11:1346022. doi: 10.3389/fcvm.2024.1346022. eCollection 2024.

Abstract

This case report presents a 72-year-old male patient who presented with exertional dyspnea for over 10 years, which had progressively worsened over the past 4 months. Transthoracic echocardiography revealed severe aortic and mitral regurgitation, with a left ventricular ejection fraction of 37% and a left ventricular end-diastolic diameter of 64 mm. Despite receiving long-term optimal medical management, there was no improvement in symptoms or severity of valvular regurgitation. Given the relatively high surgical risk associated with double valve replacement in this elderly patient and his preference for minimally invasive procedures, a one-stage transapical aortic valve replacement and transcatheter mitral valve repair using the edge-to-edge technique were planned. The patient was discharged 8 days post-procedure without any complications. At 1-month follow-up, the patient's New York Heart Association (NYHA) functional class had improved to grade II.

摘要

本病例报告介绍了一名72岁男性患者,他有超过10年的劳力性呼吸困难症状,在过去4个月中逐渐加重。经胸超声心动图显示严重的主动脉瓣和二尖瓣反流,左心室射血分数为37%,左心室舒张末期直径为64毫米。尽管接受了长期的最佳药物治疗,但症状和瓣膜反流的严重程度均无改善。鉴于该老年患者进行双瓣置换手术的风险相对较高,且他倾向于微创手术,计划采用经心尖单阶段主动脉瓣置换术和使用缘对缘技术的经导管二尖瓣修复术。术后8天患者出院,无任何并发症。在1个月的随访中,患者的纽约心脏协会(NYHA)功能分级已改善至II级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d52/10927942/0e807f7c3d18/fcvm-11-1346022-g001.jpg

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