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经导管双腔系统植入治疗重度三尖瓣关闭不全合并右心室功能障碍

[Treatment of severe tricuspid insufficiency associated with right ventricular dysfunction through the implantation of a transcatheter bi-caval system].

作者信息

Gálvez Gil Carolina, Szarfer Jorge, Albornoz Federico, Blanco Federico, Rivara Pablo, Gigena Gerardo

机构信息

Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina. E-mail:

Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2025;85(3):606-609.

Abstract

Tricuspid regurgitation (TR) is the most common condition of the tricuspid valve. It generally occurs associated with other heart diseases and was previously not considered a target for intervention. It is currently of particular interest because it was demonstrated that severe TR is associated with increased morbidity and mortality. Given the high in-hospital mortality risk of isolated tricuspid valve surgery, the early success of transcatheter repair or replacement techniques has increased access to relatively low-risk procedures. The bi-caval system is a heterotopic valve replacement therapy consisting of two self-expanding valves implanted sequentially in the superior and inferior vena cava via percutaneous access through the femoral vein. We present here the case of a 72-year-old woman with a history of chronic atrial fibrillation, mixed pulmonary hypertension, severe symptomatic TR and right ventricular dysfunction, who received percutaneous treatment with implantation of a bi-caval system associated with hemodynamic and clinic improvements.

摘要

三尖瓣反流(TR)是三尖瓣最常见的病症。它通常与其他心脏病相关联,以前不被视为干预靶点。目前它受到特别关注,因为已证明严重TR与发病率和死亡率增加相关。鉴于单纯三尖瓣手术的院内死亡风险高,经导管修复或置换技术的早期成功增加了相对低风险手术的可及性。双腔静脉系统是一种异位瓣膜置换疗法,由两个自膨胀瓣膜经股静脉经皮穿刺依次植入上腔静脉和下腔静脉组成。我们在此呈现一名72岁女性的病例,该患者有慢性房颤、混合性肺动脉高压、严重症状性TR和右心室功能障碍病史,接受了经皮治疗,植入双腔静脉系统后血流动力学和临床症状得到改善。

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