首次成功的经导管瓣内植入失败的机械二尖瓣骨折后的二尖瓣:一例报告。

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal: Case Reports Pub Date : 2025-05-09 eCollection Date: 2025-05-01 DOI:10.1093/ehjcr/ytaf183
Christian Butter, Michael Neuss, Tanja Kücken, Doreen Bensch, Michael Erb
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引用次数: 0

摘要

背景:到目前为止,功能失调的机械瓣膜必须通过手术治疗。在体外骨折实验的推动下,临床首次成功地将经导管瓣膜(TAVR)植入主动脉位置的剩余环,该入路首次被考虑用于二尖瓣位置。病例总结:一名31岁女性患者,既往有4次心内直视手术史,并伴有严重的神经系统并发症,由于机械二尖瓣假体固定倾斜导致心脏失代偿,导致二尖瓣狭窄,平均梯度大于10mmhg。讨论了一种介入方法。使用根尖通道,在大脑保护下将倾斜开裂,并顺利植入球囊植入TAVR。3年多后,患者临床稳定,瓣膜功能未受损,栓塞碎片未引起腹主动脉远端出现任何问题。讨论:据我们所知,这是第一个案例报告,证明了在破坏碳倾斜后,在失效的双小体机械二尖瓣中植入生物TAVR的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic mitral valve after fracturing the discs: a case report.

Background: Until now, dysfunctional mechanical valves had to be treated surgically. Motivated by in vitro fracture experiments and the first successful clinical implantation of a transcatheter valve (TAVR) into the remaining ring in aortic position, this approach was considered for the mitral position for the first time.

Case summary: A 31-year-old female patient with a history of four open-heart surgeries and severe neurologic complications presented with cardiac decompensation due to a fixed tilt of her mechanical bileaflet mitral valve prosthesis, resulting in mitral stenosis with a mean gradient of above 10 mmHg. An interventional approach was discussed. Using an apical access, the tilts were cracked under cerebral protection, and a balloon-implantable TAVR was implanted uneventfully. More than 3 years later, the patient is clinically stable, the valvular function is not impaired and the embolized fragment does not cause any problems in the distal abdominal aorta.

Discussion: To the best of our knowledge, this is the first case report that demonstrates the possibility to implant a biological TAVR in a failed bileaflet mechanical mitral valve after fracturing the carbon tilts.

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来源期刊
European Heart Journal: Case Reports
European Heart Journal: Case Reports Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.30
自引率
10.00%
发文量
451
审稿时长
14 weeks
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