对于失败的跨导管中膜修复装置的替代性最小侵入性外科探索技术
Serdar Akansel1,2, Markus Kofler1,2,3, Karel M Van Praet1,2,3
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), Berlin, Germany.
JTCVS techniques
|October 19, 2023
概括
在不损坏心脏门的情况下,可以通过手术扩展跨导管关修复器件 (TMVr). 针对MitraClip和PASCAL设备的量身定制技术可以在TMVr.之后解决复发的额头肌吐 (MR).
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 在老年人和高风险患者中,通过导管修复 mitra (TMVr) 装置的使用正在增加.
- 在TMVr后的复发性 mitra regurgitation (MR) 对于装置扩张和门管理提出了挑战.
研究的目的:
- 审查各种TMVr装置的临床经验.
- 为TMVr.失败的不同临床场景提出替代性手术技术.
主要方法:
- 一个模拟器系统被用来开发和记录剪贴的explantation技术.
- 在两名患者身上展示了技术,他们在TMVr.之后接受了微创性 mitra 门修复.
主要成果:
- 对MitraClip (2种技术) 和PASCAL (3种技术) 进行了具体的详细解释技术.
- 技术是根据门病理和装置封装而适应的.
- 患者成功地实现了无残留MR的探索,并在随访时保持无MR状态.
结论:
- 跨导管边缘到边缘修复装置可以在不损坏中枢的说明书的情况下进行扩展.
- 设备的移除需要量身定制的技术,考虑到封装和门病理.
- 增加的外科经验可能会改善复发性MR后TMVr的修复结果.
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