经股动脉主动脉瓣置换术中主动脉分叉支架脱位和卡住--病例报告。

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Christy Meledeth, Thomas Lambert
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引用次数: 0

摘要

经股动脉主动脉瓣置换术(TAVR)是治疗严重主动脉瓣狭窄的有效方法,尤其适用于手术风险较高的患者。TAVR 过程中腔内主动脉分叉支架移植物脱位是一种极为罕见的并发症。我们将介绍一例成功处理该并发症的病例。一名 86 岁的男性因晕厥来到急诊室。他被送入心脏科接受进一步检查。经胸超声心动图(TTE)显示主动脉严重狭窄。其他合并症包括因腹下穿透性主动脉溃疡而进行的血管内支架移植修复术。在接下来的TAVR手术中,观察到腔内支架移植物脱位。医生用卡环将异物固定在右侧髂总动脉上。患者血流动力学稳定,腔内主动脉瓣置换术顺利开始。植入主动脉瓣生物修复术后,异物从右股动脉取出。患者术后仍无症状,病情稳定。TAVR 期间腔内支架移植物脱位仍然是一种罕见的并发症。导致这种并发症的原因有多种,包括患者特有的解剖难题和手术的复杂性。决定是根据患者的个体情况做出的,但也要与介入心脏病专家团队达成共识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dislocation and Snaring of an Aortic Bifurcation Stent During Transfemoral Aortic Valve Replacement-a Case Report.

Transfemoral aortic valve replacement (TAVR) is an effective way to treat severe aortic valve stenosis, especially in patients who are high-risk for surgery. Dislocation of an endoluminal aortic bifurcation stent graft during TAVR is an extremely rare complication. We present a case on how management of this complication was successfully done. An 86-year-old man presented at the ER after syncope. He was admitted to the cardiology department for further examinations. Transthoracic echocardiography (TTE) revealed severe aortic stenosis. Other comorbidities included endovascular stent graft repair due to an infrarenal abdominal penetrating aortic ulcer. During the following TAVR procedure dislocation of the endoluminal stent graft was observed. Using a snare loop this foreign material was fixated in the right common iliac artery. The patient was hemodynamically stable and endoluminal aortic valve replacement could successfully commence. After implantation of aortic valve bioprothesis, the foreign material was retrieved from the right femoral artery. The patient remained asymptomatic and stable postprocedural. Dislocation of an endoluminal stent graft during TAVR remains a rare complication. This complication can arise due to several factors, including patient-specific anatomical challenges and procedural complexities. Decisions are based on the individual patient but are also made in consensus with the interventional cardiologist' team.

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来源期刊
CiteScore
5.40
自引率
8.70%
发文量
419
审稿时长
2 months
期刊介绍: Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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