Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA.
Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, New York, USA.
Catheter Cardiovasc Interv. 2024 May;103(6):1035-1041. doi: 10.1002/ccd.31029. Epub 2024 Mar 28.
A distinctive complication with balloon-expandable (BE) THV platforms such as the Edwards Sapien (Edwards Lifescience) is the possibility of balloon rupture during THV deployment. Balloon rupture is a rare occurrence that can result in stroke due to fragment embolism, incomplete THV expansion, and/or vascular injury upon retrieval of the balloon. Careful evaluation of preoperative computed tomography is essential to identify high-risk cases. While annular and left ventricular outflow tract (LVOT) calcification are widely acknowledged as common risks for balloon injury, it's essential to note that balloon injury can manifest at various anatomical sites. In this review, we discuss the mechanism behind balloon rupture, methods to identify cases at a heightened risk of balloon injury, approaches to mitigate the risk of rupture, and percutaneous retrieval strategies.
球囊扩张式（BE）THV 平台（如 Edwards Sapien [爱德华兹生命科学]）有一个显著的并发症，即球囊在 THV 植入过程中可能发生破裂。球囊破裂较为罕见，但可导致因碎片栓塞、THV 不完全扩张和/或球囊取出时血管损伤引起的中风。仔细评估术前 CT 是识别高危病例的关键。尽管瓣环和左心室流出道（LVOT）钙化被广泛认为是球囊损伤的常见风险因素，但需要注意的是，球囊损伤可能发生在不同的解剖部位。在本综述中，我们讨论了球囊破裂的机制、识别球囊损伤高危病例的方法、降低破裂风险的方法以及经皮取出策略。
