在一个失败的传导管边缘到边缘维修和之前的门节约根部更换后,双门维修
Ryo Fujimoto1, Shingo Hirao1, Koh Yaegashi1
1Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
JACC. Case reports
|September 26, 2025
概括
这种案例研究表明,在经过过导管边缘修复和先前的根部手术后,成功修复了双门. 术前成像指导了修复,保存了原生门,并使未来的治疗选择成为可能.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 心脏成像 - - 心脏成像
背景情况:
- 过导管边缘到边缘修复 (TEER) 和节约根置换 (VSRR) 是先进的心脏手术.
- 在初步干预后,复杂的门病理可能会出现,这会带来重大的外科手术挑战.
- 失败的TEER和先前的VSRR为后续的门维修提供了一个独特的场景.
研究的目的:
- 报告一个成功修复双门的病例,该病例发生在患有VSRR史和TEER失败的患者身上.
- 强调高级成像在规划复杂的心脏修复中的作用.
- 突出在具有挑战性的外科病例中保存本地门的可行性.
主要方法:
- 一名61岁的女性患者在VSRR后患有中度至严重的甲状腺和大动脉吐,接受了TEER.
- 并发症包括叶片撕裂和反复复发的甲状腺吐,需要手术干预.
- 双门的手术修复包括剪贴的去除,双门的修复 (叶片塑造,无塑造) 和大动脉膜的塑造 (cusp plication).
主要成果:
- 在失败的TEER和之前的VSRR之后,成功地进行了双门手术修复.
- 这一手术使得患者的原生门得以保存.
- 术前成像对于制定成功的修复策略至关重要.
结论:
- 双门修复是可行的,即使在失败的TEER和之前的根部手术后.
- 一个基于修复的策略,以成像为指导,可以保存本地门.
- 这种方法促进了未来潜在的跨导管治疗选择.
相关概念视频
Mitral Stenosis III: Medical Management
247
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
247
Aneurysm III: Interprofessional Care
255
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
255
Mitral Regurgitation III: Medical Management
284
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
284


