超导管大动脉在手术中的大动脉对于患有重复治愈内心炎的患者:一个病例报告
Yusuke Takei1, Ryujiro Suzuki2, Ikuko Shibasaki3
1Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of Medicine, Mibu-Machi, Shimotsugagun, Tochigi, Japan. y-takei@dokkyomed.ac.jp.
Surgical case reports
|September 4, 2023
概括
过导管大动脉置换是治疗已治愈的传染性内心炎的高风险患者的可行选择. 本案例研究表明,在一个有重复假体内心炎病史的患者中,门更换成功.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性疾病 传染性疾病
背景情况:
- 过导管置换通常在活跃的感染性内心炎中是禁忌的.
- 治愈后的感染性内心炎可能会对门置换手术带来独特的挑战.
- 假内心炎需要仔细考虑未来的干预措施.
研究的目的:
- 报告一个有治愈的,复发性假肢内心炎病史的患者进行过导管大动脉置换的病例.
- 评估通过导管的大动脉置换在患有已治愈感染性内心炎的高风险手术患者的安全性和有效性.
- 突出跨导管置换在以前被认为是禁忌的特定患者群体中的潜力.
主要方法:
- 一名79岁的女性,在病史中患有多次假体内心炎和生物假体衰竭,接受了跨导管大动脉置换.
- 这位患者22年前曾经接受过Bentall手术,用无支架门进行手术.
- 通过心声学和CT证实了结构膜恶化与治愈的传染性内心炎的诊断,手术风险得分高 (12.7%).
主要成果:
- 使用气球可扩展成功进行了透导管大动脉替换.
- 患者经历了一个无事件的术后过程.
- 一年后的随访没有显示出感染或门异常的迹象,这表明结构门恶化管理成功.
结论:
- 过导管替换可以是一个安全和有效的治疗选择,精心挑选的高风险的手术患者,治愈了传染性内心炎.
- 这种方法可能为患有复杂心脏病史的患者提供一种有价值的替代方案,包括假内心炎.
- 成功的结果强调了个性化治疗策略在心脏膜疾病管理中的重要性.
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