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[在经过过导管大动脉置换后心脏功能下降的患者的左束枝节奏]
Xinghong Li1, Jubo Jiang2, Sheng'an Su2
1Department of Cardiology, Songyang Branch, the Second Affiliated Hospital, Zhejiang University School of Medicine, Lishui 323400, Zhejiang Province, China. lixhongsy@163.com.
通过导管的大动脉置换 (TAVR) 可能是高风险患者的可行选择. 在TAVR引起的心力衰竭后,左束枝节奏有效地改善了心脏功能.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 严重的大动脉衰竭对接受传统门置换的老年患者构成重大风险.
- 过导管大动脉置换 (TAVR) 为高风险的外科候选人提供了一个替代方案.
研究的目的:
- 报告在患有严重大动脉功能衰竭的老年患者中成功进行跨管TAVR的病例.
- 描述TAVR后完整的左捆分支区块的开发和管理.
- 评估左束枝节奏在TAVR诱导心力衰竭后改善心脏功能的有效性.
主要方法:
- 对一位患有严重大动脉衰竭和高手术风险的老年患者进行了详细的手术前评估.
- 进行了跨管TAVR.
- 术后管理包括心力衰竭的指导方针导向医学治疗.
- 由于左心室功能持续受损,实施了左束枝节奏.
主要成果:
- 患者成功接受了跨的TAVR.
- 完整的左捆分支堵塞在术后发展,导致左心室功能受损.
- 指导方针导向的医疗疗没有显著改善心脏功能.
- 左捆分支节奏导致手术后4.5个月心脏功能明显改善.
结论:
- 跨管TAVR可以是安全有效的治疗选择高风险的老年患者严重的大动脉衰竭.
- 在TAVR后的左捆分支阻塞可以导致显著的左心室功能障碍.
- 左束枝节奏是管理TAVR诱导的心力衰竭和改善心脏功能的一种有前途的治疗策略.
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