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小儿心脏移植术后三尖瓣位旋律瓣膜植入——病例报告

Melody Valve Implantation in the Tricuspid Position After Pediatric Heart Transplantation-A Case Report.

作者信息

Saini Ashish, Kim Dennis W, Maher Kevin O, Deshpande Shriprasad R

机构信息

Division of Pediatric Cardiology, Children's Healthcare of Atlanta Cardiology, Emory University School of Medicine, Atlanta, Georgia.

Heart Transplant and Advanced Cardiac Therapies Program, Children's National Health Institute, Washington, DC.

出版信息

J Soc Cardiovasc Angiogr Interv. 2024 Feb 28;3(5):101354. doi: 10.1016/j.jscai.2024.101354. eCollection 2024 May.

Abstract

Tricuspid regurgitation (TR) is common after a heart transplant and is associated with worse clinical outcomes. The incidence ranges from 34% immediately after transplant to 20% by 10 years. Most patients can be managed medically; however, severe TR and symptomatic right heart failure warrant tricuspid valve replacement. The use of Melody transcatheter pulmonary valve in the tricuspid position is previously described. We report a unique case of posttransplant severe TR treated with surgical bioprosthetic tricuspid valve replacement who subsequently underwent successful transcatheter Melody valve placement in tricuspid position for progressive bioprosthetic valve stenosis with 11 years of follow-up.

摘要

三尖瓣反流(TR)在心脏移植后很常见,且与较差的临床结局相关。其发生率从移植后即刻的34%到10年时的20%不等。大多数患者可通过药物治疗;然而,严重的TR和有症状的右心衰竭需要进行三尖瓣置换。此前已有关于在三尖瓣位置使用Melody经导管肺动脉瓣的描述。我们报告了一例独特的病例,该病例为移植后严重TR,接受了生物人工三尖瓣置换术治疗,随后因生物人工瓣膜渐进性狭窄,在三尖瓣位置成功进行了经导管Melody瓣膜置入,并进行了11年的随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d467/11307433/7f35315cde2c/gr1.jpg

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