埃拉斯塔克利普和TMVR用于失败的TEER与传单撕裂
Amr Gamal1, Yazeed Almalki1, Thomas Attumalil1
1Structural Heart Program, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
JACC. Case reports
|November 22, 2025
概括
使用ELASTACLIP的横管甲膜置换提供了一个可行的解决方案,用于严重的横管甲膜吐 (MR) 失败后横管甲膜透器边缘到边缘修复 (M-TEER). 这种方法为高风险患者提供了最终的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 结构性心脏病 结构性心脏病
背景情况:
- 严重的 mitrale 吐 (MR) 后 mitrale 跨导管边缘到边缘修复 (M-TEER) 是不常见的.
- 在M-TEER失败后,老年并发症患者往往只有有限的治疗选择.
研究的目的:
- 在M-TEER失败后成功进行过导管 mitra 置换 (TMVR) 的案例.
- 在复杂患者中评估ELASTACLIP与TMVR结合的可行性.
主要方法:
- 一名72岁的患有扩张性心肌病症和严重功能性MR的女性接受了M-TEER.
- 在M-TEER期间发生了后部叶片撕裂,导致血液动力学不稳定性和大量MR.
- 患者随后接受了ELASTACLIP,随后接受了SAPIEN M3 TMVR.
主要成果:
- 患者的病情在综合透导管手术后立即稳定.
- 她在纽约心脏协会 (NYHA) 的II级症状和MR的痕迹下出院.
- 随访证明了稳定的临床状态和最小的残留MR.
结论:
- 失败的M-TEER与显著的残留MR存在高死亡风险,治疗选择有限.
- 埃拉斯塔克利普与TMVR相结合,对于M-TEER失败的选定患者来说,是一种可行的和最终的治疗方法.
- 这种综合方法为复杂的M-TEER后额头肌吐病例提供了安全有效的解决方案.
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