通过Redo TAVR管理的过导管的晚期迁移:三重大动脉置换的案例
Adrián Valverde Tavira1, Darío Sanmiguel Cervera2, Eva Rumiz González2
1Department of Cardiology, Consorcio Hospital General Universitario de Valencia, València, Spain.
JACC. Case reports
|October 24, 2025
概括
门中的门中的门程序很少见. 这一案例凸显了在先前的膜退化后,成功进行第三次透导管大动脉置换后,需要仔细规划和成像.
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
- 假体门疾病 假体门疾病
背景情况:
- 门内 (ViV) 程序是对退化的生物假体门进行重复手术的替代方案.
- 重复的ViV程序,或门中的门中的门,很少被报告.
- 过导管晚期退化可能需要复杂的重新干预.
研究的目的:
- 报告一个罕见的门中门中门跨导管大动脉门更换病例.
- 讨论第三次跨导管大动脉置换的挑战和考虑因素.
- 强调复杂的门干预中成像和规划的重要性.
主要方法:
- 一名76岁的男性有过大动脉置换手术和随后的ViV手术的病史,由于膜迁移和准膜泄漏,他接受了第二次ViV手术.
- 患者接受了第二个自我扩展的透导管.
- 术前成像和解剖评估对于规划至关重要.
主要成果:
- 第二次门内门手术成功进行.
- 由于第一个透气管的向下迁移迟到了,患者出现了复发性症状,导致严重的抛气管泄漏.
- 在第三次干预之前,成像证实了膜迁移和中度心室功能障碍.
结论:
- 关于第二次门内门手术后的结果的证据有限.
- 仔细的成像,解剖学评估和战略规划对于成功的第三次透导管大动脉置换至关重要.
- 这一案例突显了在一个门中的门中的门场景中管理退化的跨导管门的复杂性.
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