左心室输出管道栓塞 TAVR后的化与自扩张
Tetsuma Oyama1, Hirohisa Endo2, Atsumi Oishi1
1Department of Cardiovascular Surgery, Juntendo University Shizuoka Hospital, Izunokuni, Japan.
JACC. Case reports
|September 26, 2025
概括
在跨导管大动脉置换期间对设备进行操纵,可以排离左心室外流通道化,导致冠状动脉栓塞等严重并发症. 意识和谨慎的技术对于患者的安全至关重要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 严重的大动脉狭窄在跨导管大动脉置换 (TAVR) 期间存在重大挑战.
- 在左心室外流通道 (LVOT) 中广泛的化增加了手术风险.
研究的目的:
- 在TAVR期间报告一个LVOT化栓塞病例.
- 要突出与特定的TAVR设备操纵技术相关的潜在并发症.
主要方法:
- 一名患有严重的大动脉狭窄和广泛的LVOT化症的患者使用Navitor系统进行了TAVR.
- 内心回声心脏学指导在膜隔膜内部署,采用部分回收和远端打开技术.
- 对急性冠状动脉栓塞进行了紧急皮肤间干预.
主要成果:
- 在TAVR发生后立即,LVOT化使左主冠状动脉栓塞,导致心脏性休克.
- 通过皮肤干预成功治疗了该患者,并且在没有进一步的栓塞事件的情况下出院.
- 在手术前不移动的LVOT化在手术后变得移动,这表明设备相互作用.
结论:
- 设备操作,特别是部分重新捕获和远端打开,可能会破坏以前不移动的LVOT化.
- 对于进行TAVR的干预心脏病学家来说,意识到这种潜在的并发症至关重要.
- 仔细的技术和成像指导是必要的,以减轻与TAVR期间LVOT化相关的风险.
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