摘要
有严重症状的主动脉瓣反流与预后不良有关。根据现有指南,外科主动脉瓣置换术仍然是目前的主要治疗选择。关于经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)治疗单纯主动脉瓣反流患者的安全性和有效性的资料有限。该文报道了1例伴有心力衰竭的主动脉瓣反流患者,经过CT术前评估指定手术方案,患者术后症状明显好转,住院期间出现束支传导阻滞及腹膜后血肿,经积极治疗病情好转出院,出院前心脏超声提示反流明显好转,未见瓣周漏,心功能改善。但主动脉瓣反流仍然是TAVR具有挑战性的病例,对于经过精心挑选的单纯主动脉瓣反流患者,TAVR是一种可行和合理的选择。
Severe symptomatic native aortic regurgitation(AR) is associated with poor prognosis. Surgical aortic valve replacement is presently the main choice of treatment according to current guidelines. The data of safety and efficacy of transcatheter aortic valve replacement(TAVR) for patients with pure native AR were limited. In this paper, a case of AR patient with heart failure was reported. After preoperative CT evaluation and operation plan, the postoperative symptoms improved significantly. Bundle branch block and retroperitoneal hematoma appeared during hospitalization. After the treatment, the patient’s condition improved. Before the discharge, cardiac ultrasound indicated that the reflux was significantly improved, no perivalvular leakage was observed, and cardiac function was improved. AR remains a challenging pathology for TAVR. TAVR is a feasible and reasonable option for carefully selected patients with pure AR.
作者
朱嘉俊
赵倩
陈清杰
赵龙
杨毅宁
ZHU Jiajun;ZHAO Qian;CHEN Qingjie;ZHAO Long;YANG Yining(Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,P.R.China)
出处
《华西医学》
CAS
2020年第4期454-458,共5页
West China Medical Journal
基金
国家重点研发计划重大慢性非传染性疾病防控研究(2018YFC1312804)。
关键词
主动脉瓣反流
经导管主动脉瓣置换术
人工瓣膜
Aortic regurgitation
Transcatheter aortic valve replacement
Prosthetic valve
