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经升主动脉瘤修复术后主动脉夹层导致严重主动脉瓣关闭不全的经导管主动脉瓣植入术抢救治疗。

Transcatheter Aortic Valve Implantation Bailout for Severe Aortic Insufficiency due to Aortic Root Dissection Following Ascending Aortic Aneurysm Repair.

机构信息

Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic Florida, Weston Florida.

Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illlinois.

出版信息

Tex Heart Inst J. 2024 Nov 26;51(2):e238368. doi: 10.14503/THIJ-23-8368. eCollection 2024 Jul-Dec.

Abstract

This novel case documents the successful use of transcatheter aortic valve implantation to treat severe aortic insufficiency arising from aortic root dissection following the repair of an ascending aortic aneurysm in a 75-year-old female patient. After she presented with symptoms of congestive heart failure, investigation revealed new severe aortic insufficiency and an acute aortic dissection. Given the prohibitive risks of reoperation, a self-expanding 27-mm Portico (St Jude Medical) prosthetic aortic valve was deployed, resulting in substantial clinical improvement without procedural complications. This case highlights the versatility of transcatheter aortic valve implantation in managing complex aortic disease and emphasizes the critical role of multidisciplinary evaluation and careful prosthesis selection.

摘要

本病例报告详细描述了 1 例 75 岁女性患者,在升主动脉瘤修复术后出现主动脉根部夹层,继而引发严重主动脉瓣关闭不全,经导管主动脉瓣植入术治疗获得成功。该患者因充血性心力衰竭就诊,检查发现新出现的严重主动脉瓣关闭不全和急性主动脉夹层。鉴于再次手术风险较大,遂植入自膨式 27 毫米 Portico(圣犹达医疗用品有限公司)人工主动脉瓣,患者术后临床症状显著改善,且无手术相关并发症。本病例突出了经导管主动脉瓣植入术在处理复杂主动脉瓣疾病方面的多功能性,并强调了多学科评估和仔细选择人工瓣膜的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d65/11589360/bef6c0013975/i1526-6702-51-2-e238368-f01.jpg

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