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经导管主动脉瓣置入术患者合并右冠状动脉夹层、术后高度房室传导阻滞及急性神经损伤

TAVI PATIENT WITH RCA DISSECTION, POST-TAVR HIGH DEGREE AV BLOCK AND ACUTE NEUROLOGICAL INJURY.

作者信息

Jelić Alan, Predrijevac Mladen, Rotkvić Luka, Slivnjak Valentina, Šesto Igor, Szavits Nossan Janko, Škopljanac Mačina Andrija, Štambuk Krešimir

机构信息

Magdalena Clinic for Cardiovascular Disease at School of Medicine of JJ Strossmayer University in Osijek, Ljudevita Gaja 2, 49217 Krapinske Toplice, Croatia.

Faculty of Dental Medicine and Health, J.J. Strossmayer University in Osijek, Osijek, Croatia.

出版信息

Acta Clin Croat. 2024 Mar;63(Suppl1):111-115. doi: 10.20471/acc.2024.63.s1.21.

Abstract

TAVI (Transcatheter Aortic Valve Implantation) is a minimally invasive procedure for the treatment of severe aortic stenosis (AS) in elderly and comorbid patients. Following the guidelines of eminent cardiac societies, a decision on the treatment modality is made by the so-called "heart team". Despite being less invasive, the procedure is related to some complications, among which the most common ones are stroke, life-threatening bleeding, vascular injury, kidney injury, conduction disturbances demanding permanent pacemaker (PPM) implantation, and perivalvular leak (PVL). Here we present a case report of multiple periprocedural complications in the same patient, related to TAVI, such as right coronary artery (RCA) dissection on preoperative coronary angiography (CA), postprocedural acute neurologic injury and high grade atrioventricular (AV) block followed by PPM implantation.

摘要

经导管主动脉瓣植入术(TAVI)是一种用于治疗老年及合并症患者严重主动脉瓣狭窄(AS)的微创手术。遵循著名心脏学会的指南,由所谓的“心脏团队”做出治疗方式的决策。尽管该手术侵入性较小,但仍会引发一些并发症,其中最常见的有中风、危及生命的出血、血管损伤、肾损伤、需要植入永久起搏器(PPM)的传导障碍以及瓣周漏(PVL)。在此,我们呈现一例同一患者在TAVI围手术期出现多种并发症的病例报告,这些并发症包括术前冠状动脉造影(CA)时右冠状动脉(RCA)夹层、术后急性神经损伤以及随后需要植入PPM的高度房室(AV)阻滞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08bc/12207890/a0adff305ba5/acc-63_supp1-111-f1.jpg

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