在TAVR之后,先天性VSD的阳性重新开放
Thomas J Mason1, Lauren T Lastinger1
1Department of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
JACC. Case reports
|September 26, 2025
概括
在患有先天性心脏病的患者中,透过导管的大动脉置换 (TAVR) 可能导致获得的心脏内断路 (AICS). 在TAVR后出现新发性心力衰竭的患者中,对AICS的及时评估至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 超导管大动脉置换 (TAVR) 越来越多地用于高风险患者的严重大动脉狭窄.
- 先天性心脏病,特别是心室隔膜缺陷,在TAVR候选人中提出了独特的挑战.
研究的目的:
- 报告TAVR后获得的心内冲刺 (AICS) 的第一个已知的病例,该病例发生在患者身上,该患者先前有自发关闭的周膜心室隔膜缺陷.
- 突出VSD重新开放的潜在风险,以及TAVR之后的AICS.
主要方法:
- 病例报告详细介绍了一名患有先天性周膜性VSD的患者,他接受了TAVR.
- 描述由于TAVR后的VSD重新开放导致心力衰竭的AICS的发展.
- 通过手术关闭获得的心内静脉突变.
主要成果:
- 患者在TAVR后重新开放的室腔隔膜缺陷的继发性新发性心力衰竭.
- 获得的心内冲刺 (AICS) 被证实是心力衰竭的原因.
- 关闭AICS需要进行外科手术.
结论:
- 获得性心内静脉冲 (AICS) 是TAVR的已知的并发症,但其在患有先天性心脏病的患者中的发病率和风险因素尚未明确.
- 建议在TAVR前对患有先天性心脏病的患者进行详细的结构成像,以评估解剖学.
- 在TAVR后新发性心力衰竭需要立即对AICS进行评估,特别是在有先天性心脏缺陷病史的患者中.
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