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通过在传统上不合适的环形中与TEER在关闭中对跨导管进行链接来减少年度减少

Jeffrey Chidester¹, Leora Yarboro², James McCabe³

¹Division of Cardiovascular Medicine, University of Virginia Medical Center, Charlottesville, Virginia, USA.

JACC. Case reports

|October 25, 2025

概括

过导管边缘到边缘修复 (TEER) 结可以减少 mitra annulus 尺寸,使过导管 mitra 更换 (TMVR) 即使有过大的 annuloplasty 环. 这种技术为复杂的门干预提供了可行的解决方案.

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
心脏外科手术心脏外科手术

背景情况:

伴膜环状化 (MAC) 给跨导管伴膜置换 (TMVR) 带来了挑战.
过大尺寸的结婚整形环可以排除TMVR设备的植入.
过导管边缘到边缘修复 (TEER) 提供了一种用于环状重塑的方法.

研究的目的:

描述TEER诱导的TMVR环状缩小在患有大结膜整形环的患者中的应用.
评估在传统上不适合的解剖学中启用TMVR的可行性.

主要方法:

门式计算机断层扫描 (CT) 用于精确的解剖测量.
穿越septal左心房接入程序性方法.
中心TEER (MTEER) 具有A3-P3 commissural植入物.
如果有必要,补充前额叶叶片撕裂以防止左心室外流通道 (LVOT) 阻塞.
透气管心脏门 (THV) 的输送和部署.

主要成果:

通过使用MTEER实现了成功的环状减小.
该程序使得THV的植入成为可能,尽管有很大的无效整形环.
潜在的LVOT阻塞是通过附加的叶片撕裂来管理的.

结论:

通过在 commissure 中与 TEER 结合来减少 annular 是实现 TMVR 的可行策略.
这种技术扩大了对那些不适合标准TMVR的大型结婚整形环的患者的治疗选择.
仔细的解剖评估和程序技术对于成功的结果至关重要.

关键词:

立体成像是三维的成像.超声心电图 (Echocardiography) 是一种心声回声仪.额头门的中枢门门维修门维修门维修门的更换门的更换

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