预计在TAVI:一个案例系列期间会出现意想不到的,急性左主冠状动脉堵塞
Mohammed Saad1, Abdelrahman Elhakim1, Georg Lutter2
1Schleswig-Holstein University Hospital-Kiel, Kiel, Germany.
概括
过导管大动脉植入 (TAVI) 在复杂病例中有效治疗严重的大动脉吐. 在TAVI期间冠状动脉阻塞需要迅速干预.
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:
- 过导管大动脉植入 (TAVI) 是严重的大动脉狭窄的标准,但由于复杂的解剖学,在严重的大动脉吐 (AR) 中具有挑战性.
- 本地严重的AR病例往往呈现双膜,大环形和低化,增加了对膜泄漏和假肢迁移的风险.
研究的目的:
- 为了呈现两例严重的AR,使用TAVI使用非专用设备进行管理.
- 为了突出左主 (LM) 冠状动脉堵塞的并发症,在TAVI期间用于动脉侧.
- 讨论涉及TAVI和穿皮冠状动脉干预 (PCI) 的成功管理策略.
主要方法:
- 由于先前的手术门并发症而导致严重AR的两名患者接受了TAVI,使用自扩展门 (Navitor和Accurate Neo 2).
- 在TAVI期间,在门部署之前,左主冠状动脉封闭被确定.
- 进行了成功的TAVI植入和PCI以恢复冠状动脉流动.
主要成果:
- 两位患者都很好地忍受了这些手术,并进行了无事件的3个月的随访.
- 急性LM冠状动脉封闭是TAVI期间的关键并发症.
- 结合TAVI和PCI被证明是一个拯救生命的策略.
结论:
- 过导管植入正在扩展到复杂的解剖学和非标签性指示,如严重的AR.
- LM冠状动脉阻塞是TAVI的潜在并发症,需要考虑采取保护措施.
- 这一案例系列强调了在具有挑战性的场景中为TAVI期间的意外并发症做好准备的重要性.
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