感染性内心炎并发症与大左冠状动脉瘤:一种未定义的自然史和治疗条件
Carlos A Roldan1, Kathleen Allen1, Michelle Ratliff1
1Division of Cardiology, Albuquerque New Mexico VA Health Care System, Albuquerque, New Mexico; Division of Cardiology, University of New Mexico School of Medicine, Albuquerque, New Mexico.
The American journal of cardiology
|December 31, 2023
概括
原生大动脉感染性内心炎 (NAV-IE) 可以导致大动脉尖端动脉瘤,导致破裂和心力衰竭. 过导管大动脉置换 (TAVR) 为高风险患者提供了可行的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 传染性内心炎感染性内心炎
- 膜心脏疾病 膜心脏疾病
背景情况:
- 由于先天性大动脉感染性内心炎 (NAV-IE) 的次要原因,大动脉尖动脉瘤的自然史和治疗策略定义不佳.
- 目前的膜性心脏病指导方针不认为这种并发症是进行手术或透气管大动脉置换 (TAVR) 的迹象.
研究的目的:
- 描述了第一例报告的NAV-IE相关的大动脉尖动脉瘤患者,该患者接受了TAVR治疗.
- 突出与这些动脉瘤相关的潜在风险,并评估TAVR作为治疗选择.
主要方法:
- 病例报告:一名76岁的男性患有多种并发症,因为NAV-IE而出现左冠状动脉顶部大动脉瘤.
- 由于随后的动脉瘤破裂,严重的大动脉吐和心力衰竭,成功进行了非标签的跨导管大动脉置换 (TAVR).
主要成果:
- 该患者经历了NAV-IE的次要性左冠状动脉顶部大动脉瘤破裂,导致严重的大动脉吐和心力衰竭.
- 一个非标签的TAVR手术成功进行,管理了急性并发症.
结论:
- 由NAV-IE引起的大动脉尖动脉瘤具有明显的破裂风险,严重的大动脉吐和心力衰竭.
- 过导管大动脉置换 (TAVR) 可能是高风险的外科大动脉置换的合适替代方案,在患有NAV-IE相关的尖端动脉瘤的患者中,即使有即将破裂.
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