高风险的TAV-in-TAV:气球可扩展的TAVR在一个退化的机械扩展门中
Lida Koskina1, Andrew Ndakotsu1, Antony Kaliyadan2
1MedStar Health Georgetown University (Baltimore) Program, Baltimore, Maryland, USA.
JACC. Case reports
|October 10, 2025
概括
对于高风险患者来说,在莲花中穿过导管的大动脉内 (TAV-in-V) 是可行的. 仔细规划和冠状动脉保护策略确保成功的结果,防止冠状动脉阻塞等并发症.
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
- 医疗器械技术 医疗器械技术
背景情况:
- 越来越多地用于变性生物修饰的跨导管大动脉内 (TAV-in-V) 程序.
- 莲花门为TAV-in-V带来了独特的挑战,因为它的设计和潜在的冠状动脉阻塞.
研究的目的:
- 描述一个高风险的TAV-in-V手术在一个退化的莲花.
- 突出在特定解剖学中TAV-in-V期间冠状动脉保护的重要性.
主要方法:
- 详细的手术前评估,包括门大小和冠状动脉阻塞风险评估.
- 在门部署之前,使用专门的导管和导线进行冠状动脉接入和保护.
- 在门植入过程中使用浮潜器支架技术来保护冠状动脉.
主要成果:
- 在一个退化的莲花中成功植入了一个新的跨导管大动脉.
- 取得了有效的冠状动脉保护,防止缺血或封存.
- 部署的支架的最大扩张确保了设备的完整性.
结论:
- 莲花中的跨导管大动脉内是选择高风险患者的可行选择.
- 精心的手术前规划,适当的设备选择和积极的冠状动脉保护对于成功至关重要.
- 这种技术可以减轻与TAV-in-V手术中冠状动脉阻塞相关的风险.
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