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在患有右侧主导双大动脉的患者中进行过导管大动脉置换
Mao-Shin Lin1, Hao-Yun Liu2, Kuan-Yu Lin1
1Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
JACC. Case reports
|November 13, 2025
概括
罕见的双大动脉门 (DAA) 在跨导管大动脉置换 (TAVR) 过程中提出了挑战. 陷辅助技术可以在标准方法失败时成功导航复杂的大动脉形解剖学.
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
- 血管外科 血管外科
背景情况:
- 双大动脉 (DAA) 是一种罕见的先天性血管异常.
- 没有检测到的DAA可以使成年人中跨导管大动脉置换 (TAVR) 复杂化.
- 严重的大动脉狭窄需要TAVR,即使有复杂的血管解剖学.
研究的目的:
- 描述一个患有偶然发现的DAA的患者的TAVR病例.
- 为了突出DAA在TAVR期间所带来的挑战.
- 在DAA的背景下,为TAVR提出一个成功的管理策略.
主要方法:
- 一名71岁的妇女患有严重的大动脉狭窄和DAA,接受了TAVR.
- 装置插入是通过右大腿动脉进行的.
- 由于严重的大动脉弧扭曲,采用了陷辅助方法.
- 脑栓塞保护受到复杂的形解剖学限制.
主要成果:
- 陷辅助技术使得导航和门部署成功.
- 患者经历了一次手术后的中风.
- 复杂的形解剖学限制了脑栓塞保护的使用.
结论:
- 在DAA等罕见血管异常的患者中,全面的成像和个性化规划对于TAVR至关重要.
- 陷辅助技术在严重的大动脉弧扭曲的情况下为TAVR提供了可行的解决方案.
- 这个案例为干预医生管理类似的解剖学挑战提供了实用的见解.
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