慢性膨胀自扩张的大动脉门的管理
Sofia Hu1, Daniel Amponsah2, Sachin Malik3
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California, USA.
JACC. Case reports
|March 11, 2026
概括
过导管内折叠的延迟诊断是罕见的. 门中的门更换成功地治疗了慢性折叠,这是自扩展门的严重并发症,即使是在最初植入后的几年.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物材料科学 生物材料科学
背景情况:
- 折叠是可自扩展的跨导管的已知并发症,往往导致血液动力学妥协.
- 延迟诊断折叠是罕见的,但可能导致过早的叶片退化和有限的治疗选择.
研究的目的:
- 报告第一个慢性折叠的跨导管大动脉置换 (TAVR) 病例.
- 为了证明内更换对于慢性框架扭曲和内皮质化的有效性.
主要方法:
- 一名71岁的男性在TAVR发生5年后出现了严重的内吐.
- 经食道回声心电图发现了显著的门内折.
- 患者接受了成功的门内TAVR,以纠正大动脉功能不充分.
主要成果:
- 门内门TAVR手术成功解决了严重的大动脉衰竭.
- 慢性折叠,即使是TAVR几年后,也可以通过3D计算机断层扫描来可视化.
- 自扩展门的结构扭曲可以通过高压门整形和门内门更换来管理.
结论:
- 这一病例是首次报告慢性折叠的TAVR,这是自扩展门的罕见并发症.
- 过导管内折叠可能并不总是呈现出显著的血液动力学变化,可能会延迟诊断.
- 门中的门更换是一种有效的策略,用于管理TAVR设备中的慢性结构扭曲和内皮质.
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