在长期使用皮质类固醇的人体中,通过导管更换大动脉的环状破裂:一个病例报告
Hironobu Nishiori1, Kaoru Matsuura1, Yasunori Yakita1
1Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.
Journal of surgical case reports
|June 1, 2023
概括
慢性皮质类固醇使用可能会增加大动脉环状破裂的风险在跨导管大动脉置换 (TAVR) 期间. 仔细的气球扩张至关重要,特别是气球可扩展门,以防止并发症.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心血管外科心血管外科
背景情况:
- 严重的大动脉狭窄需要先进的治疗选择.
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的一种最少侵入性的替代方案.
- 长期使用口服皮质类固醇可以影响组织完整性.
研究的目的:
- 在慢性皮质类固醇治疗患者的TAVR期间报告大动脉环状破裂病例.
- 突出潜在的风险因素和管理这种并发症.
- 强调谨慎的程序技巧的重要性.
主要方法:
- 一名74岁的女性患者患有严重的大动脉狭窄,并有9年的口服皮质类固醇使用史,接受了输血TAVR.
- 一个26毫米的SAPIEN 3气球可扩展被部署.
- 在手术过程中使用过食管的心声学和血管学进行评估.
主要成果:
- 在上升性大动脉周围观察到大动脉环中的出血和对比泄漏在门部署后.
- 一个新兴的外科动脉置换成功地进行了修复环状撕裂.
- 患者康复良好,并在术后的第14天出院,并没有出现膜泄漏.
结论:
- 慢性皮质类固醇使用可能是TAVR期间大动脉环状破裂的危险因素.
- 仔细的气球扩张是必不可少的,特别是在长期使用皮质类固醇的患者的气球扩展.
- 及时识别和手术干预对于管理TAVR相关的环状断裂至关重要.
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