当其他一切都失败时:TricValve®在透析依赖的患者中使用,患者患有高级右心力衰竭
Aristi Boulmpou1, Alexandros Kallifatidis2, Panagiotis Charalampidis2
1St. Luke's Hospital, Panorama, Thessaloniki, Greece;Third Department of Cardiology, Aristotle University of Thessaloniki, Ippokrateio General Hospital, Thessaloniki, Greece.
概括
使用TricValve®系统进行皮肤穿式门植入,成功治疗了在依赖透析的患者中严重的三角管吐. 这种最少的侵入性方法稳定了血液动力学,并改善了高风险个体的康复.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 在透析的末期病 (ESRD) 患者往往有复杂的心血管疾病.
- 严重的三回 (TR) 显著影响右心功能,并可能使ESRD患者的治疗复杂化.
- 由于手术风险过高,患有严重TR的高风险ESRD患者面临有限的治疗选择.
研究的目的:
- 报告TricValve®系统植入在严重TR的透析依赖患者中的第一个欧洲病例.
- 评估皮肤穿式马植入在高风险ESRD患者中的可行性和治疗价值.
主要方法:
- 一名72岁的男性ESRD患者患有严重的TR,低血压和心脏性休克,经历了TricValve®系统的紧急皮肤穿式马植入.
- 由于广泛的环状扩张,被认为不适合进行跨导管边缘到边缘的修复.
主要成果:
- 在技术上,TricValve®程序是成功的,实现了立即的血液动力学稳定.
- 患者经历了替代疗法的改善耐受性和快速的临床康复.
- 后续成像证实了设备的最佳放置,没有并发症.
结论:
- 使用TricValve®系统进行皮肤穿式门植入,对于经过精心挑选的,高风险的透析依赖的重症TR患者来说,是一种可行且有效的治疗方法.
- 这种微创方法在传统的手术或透导管选择不可行时提供了治疗替代方案.
相关概念视频
01:20Mitral Regurgitation I: Introduction
381
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
381
01:21Cardiac Catheterization II: Right Heart Catheterization
754
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
754
01:22Heart Failure VI: Adjunct Therapies
235
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
235
01:24Hemodialysis II: Procedure and Complications
573
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
573
01:30Cardiomyopathy II: Dilated Cardiomyopathy
447
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
447
01:22Heart Failure Drugs: Diuretics
768
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
768