股静脉-房间隔途径经导管二尖瓣置换术一例  

Valve in Valve transcatheter mitral valve replacement by a transvenous,transseptal access:A case report

作　　者：魏家富[1] 陈飞[1] 蒙炜[2] 魏薪[1] 彭勇[1] 李侨[1] 何森[1] 李怡坚 郑明霞[1] 周轩[3] 陈果[4] 冯沅[1] 陈茂[1] WEI Jiafu;CHEN Fei;MENG Wei;WEI Xin;PENG Yong;LI Qiao;HE Sen;LI Yijian;ZHENG Mingxia;ZHOU Xuan;CHEN Guo;FENG Yuan;CHEN Mao(Department of Vasculocardiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Radiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China;Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心血管内科,成都610041 [2]四川大学华西医院心脏大血管外科,成都610041 [3]四川大学华西医院放射科,成都610041 [4]四川大学华西医院麻醉科,成都610041

出　　处：《中国胸心血管外科临床杂志》2021年第1期122-124,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81970325);四川大学华西医院学科卓越发展1·3·5工程项目。

摘　　要：生物瓣膜衰败后二次开胸换瓣是导致心外科手术高风险的重要因素。2020年ACC/AHA指南推荐经导管二尖瓣植入瓣中瓣作为高风险患者的替代方案。本文报道了1例77岁二尖瓣生物瓣衰败男性患者,经评估为外科高风险,行股静脉-房间隔途径的经导管二尖瓣置换。患者术后3 h在CCU拔除气管插管,无气促等不适,术后第1 d转出监护室,第3 d出院。相比心尖途径,股静脉-房间隔途径创伤更小,更早脱离监护室,更早康复出院。Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries.In2020 ACC/AHA guideline,Valve in Valve(Vi V)was recommended for high-risk patient instead of surgical mitral valve replacement.This report described a 77-year-old male patient with a failed mitral bioprosthetic valve,evaluated at high risk of surgery,received a transvenous,transseptal transcatheter mitral valve replacement(TMVR).Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea.The patient was transferred out of the CCU and discharged on the 3 rd day.Compared with transapical access,transvenous transseptal access was less invasive,with shorter duration in CCU and hospitalization.

关 键 词：二尖瓣置换 经房间隔 经股静脉 经导管 瓣中瓣 

分 类 号：R654.2[医药卫生—外科学]