Combined transapical transcatheter aortic valve implantation and premature ventricular contraction ablation in a high-risk cardiomyopathy patient: a case report.

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal: Case Reports Pub Date : 2025-09-06 eCollection Date: 2025-09-01 DOI:10.1093/ehjcr/ytaf441

Yu-Bin Li, Yang Wu, Chen Su, Zhong-Kai Wu, Li-Chun Wang

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Abstract

Background: Frequent premature ventricular contractions (PVCs) and valvular dysfunction are established contributors to worsening heart failure.

Case summary: We present a 67-year-old male with dilated cardiomyopathy, severe aortic regurgitation, and unifocal left ventricle-originated PVCs (37.8% burden) refractory to guideline-directed medical therapy and cardiac devices. Due to high surgical risk, a combined transapical transcatheter aortic valve implantation and PVC ablation was performed. Postoperatively, PVCs were eliminated, left ventricular ejection fraction improved from 35% to 55%, and cardiac dimensions normalized significantly.

Discussion: This case highlights the feasibility of a single apical approach for addressing both valvular and arrhythmic pathologies in high-risk patients, offering a novel strategy to mitigate heart failure progression.

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高危心肌病患者经尖经导管主动脉瓣植入术联合室性早搏消融1例。

背景：频繁的室性早搏和瓣膜功能障碍是导致心力衰竭恶化的因素。病例总结：我们报告了一位67岁男性扩张型心肌病，严重主动脉反流，单灶性左心室源性室性心动过速（37.8%负担），指南指导的药物治疗和心脏装置难以治愈。由于手术风险高，我们进行了经根尖经导管主动脉瓣植入术和PVC消融联合手术。术后，室性早搏消失，左室射血分数从35%提高到55%，心脏尺寸明显正常化。讨论：本病例强调了单根尖入路治疗高危患者瓣膜性和心律失常病理的可行性，提供了一种缓解心力衰竭进展的新策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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