class='kwd-title'>Keywords: Transcatheter mitral'/> Transcatheter Aortic Valve Replacement to Treat Left Ventricular Outflow Tract Obstruction and Significant Paravalvular Leak Following Transcatheter Mitral Valve Replacement
首页> 美国卫生研究院文献>CASE : Cardiovascular Imaging Case Reports >Transcatheter Aortic Valve Replacement to Treat Left Ventricular Outflow Tract Obstruction and Significant Paravalvular Leak Following Transcatheter Mitral Valve Replacement
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Transcatheter Aortic Valve Replacement to Treat Left Ventricular Outflow Tract Obstruction and Significant Paravalvular Leak Following Transcatheter Mitral Valve Replacement

机译:经导管二尖瓣置换术后主动脉瓣置换术治疗左心室流出道梗阻和明显的瓣周漏

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摘要

class="kwd-title">Keywords: Transcatheter mitral valve replacement, Paravalvular leak, Hemolysis, Transcatheter aortic valve replacement class="head no_bottom_margin" id="sec1title">IntroductionMitral regurgitation (MR) is a leading cause of valvular heart disease, but up to half of patients with moderate to severe MR are not referred for conventional mitral valve surgery, because of advancing age or multiple comorbidities. Transcatheter mitral valve replacement (TMVR) with the Tendyne device (Abbott Vascular, Santa Clara, CA) is an alternative therapy for a subset of patients with significant MR at prohibitive operative risk because it does not require cardiopulmonary bypass or sternotomy., , Potential complications of TMVR devices include fixation of the native anterior mitral valve leaflet (AMVL) in the left ventricular outflow tract (LVOT) in systole, which may result in systolic anterior motion (SAM) of the AMVL and potential LVOT obstruction and paravalvular leak (PVL). We report a case of profound intravascular hemolysis causing acute kidney injury because of PVL and LVOT obstruction following Tendyne TMVR. Although PVL closure was attempted, definitive treatment was achieved with transcatheter aortic valve replacement (TAVR), which corrected both PVL and LVOT obstruction, with complete resolution of hemolysis and improvement of renal function.
机译:<!-fig ft0-> <!-fig @ position =“ anchor” mode =文章f4-> <!-fig mode =“ anchred” f5-> <!-fig / graphic | fig / alternatives / graphic mode =“ anchored” m1-> class =“ kwd-title”>关键字:经导管二尖瓣置换,瓣周漏,溶血,经导管主动脉瓣置换 class =“ head no_bottom_margin二尖瓣反流(MR)是瓣膜性心脏病的主要原因,但由于年龄增长,多达一半的中度至重度MR患者未接受常规二尖瓣手术或多种合并症。使用Tendyne装置(美国加利福尼亚州圣克拉拉市的Abbott Vascular,CA)进行经导管二尖瓣置换术(TMVR)是另一种对具有显着MR风险且具有较高手术风险的患者亚组的替代疗法,因为它不需要进行体外循环或胸骨切开术。 TMVR设备包括将天然的前二尖瓣小叶(AMVL)固定在收缩期的左心室流出道(LVOT)中,这可能导致AMVL的收缩前运动(SAM)以及潜在的LVOT阻塞和瓣周漏(PVL) 。我们报告了一个严重的血管内溶血病例,由于Tendyne TMVR后由于PVL和LVOT阻塞而引起急性肾损伤。尽管尝试了PVL封闭,但通过经导管主动脉瓣置换术(TAVR)进行了明确的治疗,该术式纠正了PVL和LVOT阻塞,并完全解决了溶血作用并改善了肾功能。

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