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感染性心内膜炎中经导管主动脉瓣置换术的手术入路:一种描述性技术

Surgical Approach for TAVI Replacement in Endocarditis: A Descriptive Technique.

作者信息

D'ulisse Sébastien, Homsy Karim, Marinakis Sotirios, Cappeliez Serge, El Nakadi Badih

机构信息

Marie Curie Hospital, Université Libre de Bruxelles (ULB), 6042 Charleroi, Belgium.

Cardiac Surgery, Marie Curie Hospital, 6042 Charleroi, Belgium.

出版信息

J Clin Med. 2025 Mar 29;14(7):2348. doi: 10.3390/jcm14072348.

Abstract

Transcatheter Aortic Valve Implantation (TAVI) has significantly improved the management of aortic valve disease, but post-TAVI infective endocarditis, occurring in 0.5-3.1% of cases, remains a serious complication. Due to a high mortality rate and technical challenges, surgical replacement of infected TAVI prosthetic valves is performed in only 11.4% of cases. This case describes a standardized surgical technique for the removal and replacement of self-expanding TAVI prosthetic valves in the case of infective endocarditis. The proposed approach aims to facilitate valve explantation while minimizing surgical risks. We believe that this technique could be particularly beneficial for surgeons managing these complex cases, by reducing surgical complications and improving patient outcomes. Further studies are necessary to validate its long-term efficacy and applicability in broader clinical settings.

摘要

经导管主动脉瓣植入术(TAVI)显著改善了主动脉瓣疾病的治疗,但TAVI术后感染性心内膜炎的发生率为0.5%-3.1%,仍然是一种严重的并发症。由于死亡率高且存在技术挑战,仅11.4%的病例会进行感染的TAVI人工瓣膜的外科置换。本病例描述了在感染性心内膜炎情况下,用于取出和置换自膨胀TAVI人工瓣膜的标准化手术技术。所提出的方法旨在便于瓣膜取出,同时将手术风险降至最低。我们认为,该技术通过减少手术并发症并改善患者预后,可能对处理这些复杂病例的外科医生特别有益。有必要进行进一步研究,以验证其在更广泛临床环境中的长期疗效和适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/793f/11989709/aebcf7f67ce6/jcm-14-02348-g001.jpg

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