“一站式”经导管主动脉瓣置换联合经皮腔内室间隔心肌消融手术1例  

One-stop transcatheter aortic valve replacement combined with percutaneous transluminal septal myocardial ablation:a case report

作　　者：侯士强 潘文志 陆浩 李伟 陈莎莎 周达新 葛均波 HOU Shi-qiang;PAN Wen-zhi;LU Hao;LI Wei;CHEN Sha-sha;ZHOU Da-xin;GE Jun-bo(Shanghai Institute of Cardiovascular Disease-Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院心内科-上海市心血管病研究所,上海200032

出　　处：《复旦学报（医学版）》2021年第2期281-284,共4页Fudan University Journal of Medical Sciences

基　　金：国家重点研发计划(2017YFC1104202-2)。

摘　　要：经导管主动脉瓣置换术(transcatheter aortic valve replacement,TAVR)是治疗主动脉瓣狭窄(aortic valve stenosis,AS)的一种成熟手段。AS患者几乎均合并心肌肥厚,目前对于合并梗阻性肥厚型心肌病(hypertrophic obstructive cardiomyopathy,HOCM)的AS患者首先考虑外科手术而非TAVR。但高龄、高危患者常不能耐受外科手术,介入手段能否安全有效治疗此类患者尚存疑问。本文报道1例77岁女性患者,重度AS合并HOCM,经评估后行“一站式”TAVR联合经皮腔内室间隔心肌消融术(percutaneous transluminal septal myocardial ablation,PTSMA),术后患者恢复良好。本病例为国内开展的首例“一站式”TAVR+PTSMA,为TAVR术中紧急处理并发症和拓宽适应证提供新的依据。Transcatheter aortic valve replacement(TAVR)is a mature method to treat aortic valve stenosis(AS).Almost all patients with AS have cardiac hypertrophy.At present,AS patients with hypertrophic obstructive cardiomyopathy(HOCM)are recommended for surgery firstly,not TAVR.However,the elderly and high-risk patients often cannot tolerate surgery,and whether intervention can treat such patients safely and effectively is still questionable.This paper reports that a 77-year-old female patient with severe AS and HOCM underwent one-stop TAVR+percutaneous transluminal septal myocardial ablation(percutaneous transluminal septal myocardial ablation,PTSMA)on the basis of careful evaluation.The patient is recovering well.This case is the first one-stop TAVR+PTSMA developed in China,providing a new basis for the treatment of emergency complications during TAVR and the expansion of indications.

关 键 词：主动脉瓣狭窄(AS) 肥厚型心肌病 经导管主动脉瓣置换术(TAVR) 经皮腔内室间隔心肌消融术(PTSMA) 

分 类 号：R543.1[医药卫生—心血管疾病]