增加GORE®心形ASD遮蔽器的尺寸,以治疗心房膜缺陷与心房膜动脉瘤
Hiromasa Hayama1, Kenji Makino1, Yoshiyuki Yazaki1
1Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, JPN.
Cureus
|July 29, 2024
概括
与动脉瘤相关的心房隔膜缺陷 (ASD) 的跨导管关闭可能是复杂的. 一个更大的GORE® Cardioform ASD Occluder设备成功地在一个具有挑战性的secundum ASD病例中管理了边缘泄漏.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 前庭隔膜缺陷 (ASDs) 可以呈现复杂的解剖学,包括专利的卵孔 (PFO) 和前庭隔膜动脉瘤 (ASAs).
- 过导管关闭是ASD的常见治疗方法,但具有挑战性的解剖学可能需要专门的方法.
- 与ASA和PFO共存的ASD管理存在独特的程序性困难.
研究的目的:
- 报告一个复杂的副心房隔膜缺陷 (ASD) 病例,其中包括心房隔膜动脉瘤 (ASA) 和圆孔 (PFO).
- 用GORE® Cardioform ASD Occluder (GCA) 来描述复杂的ASD的顺利关闭.
- 为了说明在存在大型移动ASA时管理与设备相关的边缘泄漏的技术.
主要方法:
- 一个50多岁的男性患者的病例报告,患有第二次ASD,ASA和PFO.
- 通过气球大小测量进行的GORE® Cardioform ASD Occluder (GCA) 的初始植入.
- 通过在受控的ASA运动下植入更大的GCA设备来管理持续的边缘泄漏.
主要成果:
- 最初的GCA设备植入导致边缘泄漏,这是由于大型ASA的动态性质造成的.
- 随后植入了两大尺寸的GCA装置,成功地实现了ASD的完全关闭.
- 该程序通过控制装置植入期间的ASA运动来有效执行.
结论:
- 复杂的ASD与相关的ASAs的透导管关闭是可行的.
- 设备的选择和尺寸在管理具有具有具有挑战性的解剖特征的ASD方面至关重要,例如大型移动的ASA.
- 使用更大的设备和可控制的ASA运动可以有效地解决复杂ASD关闭的边缘泄漏问题.
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