Hainstock Michael R, Castro Barbara A, Kidney Stephanie R, Lim D Scott
Division of Pediatric Cardiology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA.
Division of Pediatric Cardiac Anesthesia, Department of Anesthesia, University of Virginia, Charlottesville, Virginia, USA.
JACC Case Rep. 2024 Aug 21;29(16):102475. doi: 10.1016/j.jaccas.2024.102475.
Transcatheter pulmonary valve replacement (TPVR) is complicated in patients without adequate femoral or internal jugular vascular access. Transhepatic vascular access has been shown to be safe and effective across a spectrum of diagnostic and interventional procedures. Closure of the hepatic venous tract can be accomplished with a multitude of readily available vascular occlusion devices. The rates of major adverse events are low: 5% to 8% with hemoperitoneum and complete heart block are most significant. To our knowledge, this is the first report of using transhepatic access for TPVR; closure of the hepatic venous tract was achieved with an Amplatzer vascular plug type II.
对于没有足够股动脉或颈内静脉血管通路的患者，经导管肺动脉瓣置换术（TPVR）操作复杂。经肝血管通路已被证明在一系列诊断和介入手术中是安全有效的。肝静脉通路的闭合可以通过多种现成的血管闭塞装置来完成。主要不良事件的发生率较低：腹腔积血发生率为5%至8%，完全性心脏传导阻滞最为显著。据我们所知，这是首例关于使用经肝通路进行TPVR的报告；使用II型Amplatzer血管封堵器实现了肝静脉通路的闭合。
