在感染性内心炎的ViV-TAVR后出现严重的围膜,随着SAVR伴随多种并发症
Yuan Cao1, Xiangjuan Liu1, Lianyue Ma1
1Department of Cardiology, Qilu Hospital of Shandong University, National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Jinan, China; Cheeloo College of Medicine, Shandong University, Jinan, China.
JACC. Case reports
|February 5, 2026
概括
内透管大动脉置换 (ViV-TAVR) 可能是高风险患者之前感染性内心炎 (IE) 的选择. 优化的术后抗生素至关重要,即使在感染解决后,以改善结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 假肢管管理 假肢管管理
背景情况:
- 过导管大动脉置换 (TAVR) 通常在活性传染性内心炎 (IE) 中是禁忌的.
- 门内TAVR (ViV-TAVR) 对具有假体门功能障碍和IE病史的高风险患者提供了潜在的替代方案.
研究的目的:
- 为了说明ViV-TAVR在一个具有IE病史和假体膜恶化的高风险患者中的应用.
- 强调在这种复杂的病例中,量身定制的,加强的术后抗生素策略的重要性.
主要方法:
- 一个高风险患者的案例研究,在之前的IE之后,生物假体大动脉的结构的恶化.
- 由于手术风险很高 (STS PROM 10.2%),患者在一年的抗菌疗法后接受了ViV-TAVR.
主要成果:
- 在ViV-TAVR检测后一个月检测到一个围腹.
- 患者最终在手术后三个月因严重胃肠道出血而死亡.
结论:
- 在某些患有治愈的IE的高风险患者中,可以考虑使用ViV-TAVR,这取决于确诊的感染解决.
- 个性化,优化的术后抗感染疗法是必不可少的,考虑到患者的并发病和感染史.
- 糖尿病可能是这种患者群体中与不良结果相关的危险因素.
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