在复杂的临床场景中,具有挑战性的重复中枢片手术
Abed Qadan1, Shemy Carasso1, Mony Shuvy1
1Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
JACC. Case reports
|October 3, 2025
概括
在患有先前心房隔膜缺陷 (ASD) 封闭症的患者中,可行的是Redo跨导管边缘到边缘修复 (TEER). 精心规划和精确的技术使得成功重复TEER,即使是复杂的解剖学.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 结构性心脏病是什么
背景情况:
- 过导管边缘到边缘修复 (TEER) 是高风险患者严重额头吐的关键治疗方法.
- 重制TEER手术带来了独特的挑战,特别是当被先前的干预措施 (如心房隔膜缺陷 (ASD) 关闭装置) 复杂化时.
- 这些先前的设备可以在随后的程序中阻碍访问和设备操作.
研究的目的:
- 报告一个先前植入ASD封闭器的患者成功重复TEER的病例.
- 为了展示一种新的方法,在存在ASD封闭器的情况下进行跨septal穿刺.
- 强调在复杂的重复TEER案例中精细规划和执行的重要性.
主要方法:
- 一名60岁的男性患有严重的功能性心肌吐和非血性扩张性心肌病,接受了重复TEER.
- 一个先前植入的ASD封闭器提出了一个重要的解剖学挑战.
- 在没有设备互动的情况下,成功地在ASD封闭器旁边进行了跨septal穿刺.
主要成果:
- 新的跨septal访问方法促进了重复TEER程序的成功完成.
- 没有遇到任何程序性并发症.
- 通过这种干预,患者的临床状况得到了有效的管理.
结论:
- 在有ASD闭塞植入病史的患者中,重复TEER是可行的.
- 细致的手术前规划,精确的穿越穿孔和小心的设备处理对于手术成功至关重要.
- 先进的成像和多学科合作对于管理这些复杂的病例至关重要.
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