Bernat Robert, Windmüller Volker, Leivaditis Vasileios, Dahm Manfred, Schumacher Burghard
Westpfalz-Klinikum Kaiserslautern, Germany.
Medical School Osijek, Croatia.
Acta Clin Croat. 2024 Mar;63(Suppl1):86-89. doi: 10.20471/acc.2024.63.s1.16.
Valve-in-Valve (ViV) procedures for failed surgical bioprostheses are becoming increasingly common. We present a case of a 73-year-old male patient with significant comorbidities who underwent a primary transcatheter aortic valve implantation (TAVI) with an Evolut 29 mm (Medtronic, Minneapolis, MN, USA) valve. This TAVI-prosthesis implantation failed due to the inability to fix the valve at the appropriate height to achieve an optimal hemodynamic result. The valve had to be snared and pulled into an adequate position and was then fixed by an implantation of another TAVI-prosthesis (29 mm Sapien S3, Edwards Lifesciences, Irvine, CA, USA) with optimal final result. The patient was discharged after significant clinical improvement and without further complications.
对于手术植入失败的生物瓣膜进行瓣中瓣(ViV)手术正变得越来越普遍。我们报告一例73岁男性患者,该患者有多种严重合并症,接受了首次经导管主动脉瓣植入术(TAVI),植入一枚29毫米的Evolut瓣膜(美敦力公司,美国明尼阿波利斯市)。此次TAVI瓣膜植入失败,原因是无法将瓣膜固定在合适高度以实现最佳血流动力学结果。该瓣膜不得不被圈套并拉至合适位置,随后通过植入另一枚TAVI瓣膜(29毫米的Sapien S3,爱德华生命科学公司,美国加利福尼亚州尔湾市)进行固定,最终取得了最佳效果。患者在临床症状显著改善后出院,且无进一步并发症。