一个感染的莲花边的外科扩张:一个病例报告
Yusuke Yanagino1, Satoshi Kainuma2, Naonori Kawamoto2
1Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan. beats.process@gmail.com.
General Thoracic and Cardiovascular Surgery Cases
|December 21, 2024
概括
透导管大动脉置换 (TAVR) 试验莲花边的试验具有挑战性. 冷盐水灌可以在假内心炎的情况下促进这些难以移植的门的去除.
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
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管大动脉置换 (TAVR) 的使用正在增加,导致TAVR门扩张的增加.
- 关于莲花边门开口的报道很少,数据有限,没有手术视频可用.
- 假体内心炎 (PVE) 和大动脉环状需要TAVR探索和外科大动脉置换 (AVR).
研究的目的:
- 报告一个因PVE和大动脉环状瘤而导致的莲花边门扩张病例.
- 描述用于探索和随后手术AVR的方法.
- 突出管理困难的TAVR门扩张的潜在技术.
主要方法:
- 在TAVR 2年后,在一个患有PVE和心脏阻塞的85岁男性身上进行了莲花边门扩张.
- 通过阳性血液培养,表达植被的心声学和CT扫描显示大动脉根异常的诊断证实了诊断.
- 爆炸涉及用子使门变形,并使用冷盐水灌来软化尼醇支架,以便从大动脉壁切割.
主要成果:
- 通过冷盐水灌实现了莲花边缘门的成功扩张.
- 使用Avalus生物假体门和心脏起器植入的外科AVR同时进行.
- 患者在术后表现出良好的假体门功能,并在抗菌药物治疗后出院接受康复.
结论:
- 由于部署后的强固和粘附,Lotus Edge门的扩张具有挑战性.
- 冷水灌可能是一个有效的方法,以促进切除莲花边.
- 这一案例证明了在感染的背景下管理复杂的TAVR扩散的成功方法.
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