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在TAVR过程中突发性大动脉动脉瘤和大动脉剖析与救援双边大动脉支架

Sumon Roy¹, Alexis Lauria², Rohan Kalathiya²

¹Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Division of Cardiology, Boston Medical Center Health System, Boston, Massachusetts, USA.

JACC. Case reports

|May 23, 2025

概括

过导管大动脉置换 (TAVR) 可以导致大动脉损伤. 这一案例突显了TAVR期间使用多学科内血管技术成功管理罕见的大动脉并发症.

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
血管外科血管外科

背景情况:

大动脉损伤是跨导管大动脉置换 (TAVR) 的严重并发症,在0.6%至1.9%的手术中发生.
严重的大动脉狭窄和外围动脉疾病增加了手术风险.

研究的目的:

在TAVR期间报告一种罕见的导管诱导的突发性动脉动脉瘤病例.
描述这种大动脉并发症的成功内血管管理.

主要方法:

一名患有严重的大动脉狭窄并亲吻腹腔支架的患者接受了TAVR.
在推进过程中,观察到一个化质量与TAVR导管一起移动.
血管造影证实了导管诱导的无穿孔的突发性动脉瘤.

主要成果:

经过仔细切除TAVR导管,动脉瘤被通过下线重新定位.
接吻阴茎支架进行了覆盖移动斑块.
术后血管造影显示出专利支架和优秀的远端大动脉和下肢流水.

结论:

在TAVR期间的大动脉并发症虽然很少见,但可能危及生命.
迅速的多学科干预对于成功的内血管管理这些事件至关重要.

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