顺序性酒精隔膜切除,以解决LV外流通道阻塞,经过透气管中枢替换后的LV外流通道阻塞
Mark M P van den Dorpel1, Mauricio Felippi de Sá Marchi2, Sarah Verhemel1
1Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
JACC. Case reports
|February 16, 2024
概括
左心室外流通道阻塞 (LVOTO) 是通过导管中枢置换 (TMVR) 后的一个严重风险. 顺序性酒精隔膜切除 (ASA) 在一个具有挑战性的案例中成功解决了意想不到的LVOTO.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗成像医学成像
背景情况:
- 左心室外流通道阻塞 (LVOTO) 是经过透气管 mitra 置换 (TMVR) 后的一个已知的并发症.
- 使用计算机断层扫描 (CT) 的预测建模可以识别患新LVOTO风险的患者.
- 酒精隔膜切除 (ASA) 是一个潜在的策略来减轻这种风险.
研究的目的:
- 报道一个新的案例,在TMVR后管理意想不到的新LVOTO.
- 为了证明顺序性酒精隔膜切除 (ASA) 在解决新LVOTO的疗效.
- 突出一种用于管理TMVR相关并发症的替代方法.
主要方法:
- 利用计算机断层扫描 (CT) 进行手术前规划和风险评估.
- 执行过导管中枢替换 (TMVR).
- 进行了序列性酒精隔膜切除 (ASA),针对两个相邻的隔膜分支来解决新出现的LVOTO.
主要成果:
- 意想不到的新LVOTO发生在TMVR后.
- 两个相邻的隔膜分支的顺序ASA有效地解决了新-LVOTO.
- 患者耐受了连续的ASA程序,没有立即的并发症.
结论:
- 序列性ASA可以成为TMVR后意想不到的新LVOTO的可行和有效的治疗方法.
- 这个案例扩大了管理TMVR并发症的干预选择.
- 在这种情况下,仔细的患者选择和程序技术对于成功的ASA至关重要.
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