旋转切除术后的大动脉破伤:一个病例报告
Farrah Othman1, Gerald Yong1, Alan Whelan1
1Department of Cardiology, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, Perth, WA 6150, Australia.
European heart journal. Case reports
|June 7, 2024
概括
由旋转性心脏切除术引起的阳性性大动脉损伤很少见,但可能导致严重的大动脉吐. 超导管大动脉置换是不适合手术的患者的可行的治疗选择,需要仔细监测并发症,如低衰减的叶片加厚.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 在心血管导管治疗过程中,有机性大动脉损伤是一种罕见但严重的并发症.
- 这种损伤导致的严重大动脉反 (AR) 通常需要手术干预.
- 由于解剖学因素和当前跨导管技术的局限性,通过皮肤治疗本地纯AR具有挑战性.
研究的目的:
- 在轮转性心脏切除术后报告严重的阴性大动脉吐病例.
- 讨论通过导管对非手术候选人的原生纯AR进行大动脉置换 (TAVR) 的可行性.
- 突出识别和管理并发症的重要性,例如低衰减的叶片加厚 (HALT).
主要方法:
- 一个病例报告,一名82岁的女性在轮转性心脏切除术后发展出严重的AR.
- 心声学和4DCT成像被用于诊断和监测.
- 用超大小的门进行了透导管大动脉替换.
- 手术后的治疗包括对HALT和血栓的抗凝药.
主要成果:
- 成功植入一个超大尺寸的跨导管大动脉,用于严重的本地AR.
- 在TAVR后,急性肺的消失和正常门功能的恢复.
- 治疗后出现低衰减叶片增厚 (HALT) 和血栓的发展,用抗凝药治疗.
- 在中风后完全神经恢复和成功治疗门相关并发症.
结论:
- 阴道动脉的创伤,虽然很少见,但需要在旋转切除术期间仔细考虑.
- 超导管大动脉置换是一种可行的选择,可用于手术不合格的患者严重的本源性大动脉吐.
- 早期发现和管理HALT对于TAVR后的最佳结果至关重要.
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