A case of transcatheter mitral valve-in-valve implantation by Sapien 3 via the transfemoral-atrial septum route
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摘要: 本文报道1例因二尖瓣生物瓣衰败导致心力衰竭的患者，急需行瓣膜置换术。多学科团队决定使用Sapien 3瓣膜经股静脉-房间隔途径行经导管二尖瓣瓣中瓣植入术。术后患者恢复良好，随访发现患者心功能明显改善，超声心动图提示Sapien 3瓣膜工作正常。Abstract: This article reported a case of heart failure due to mitral bioprosthetic valve failure that urgently needs to be solved. The multidisciplinary team decided to perform transcatheter mitral valve-in-valve implantation by Sapien 3 via the transfemoral-atrial septum route. The patient recovered well after surgery. Follow-up showed significant improvement in cardiac function and echocardiography indicated the Sapien 3 valve was working normally.
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图 1 术前心脏彩超及CT重建
Figure 1. Echocardiography and multi-detector computed tomography before operation
表 1 患者术前、术后及随访4个月后心脏彩超
Table 1. Echocardiography before operation, after operation and after 4 months of follow-up
心脏彩超数据 术前1个月 术后床旁 术后3 d 术后1周 术后1个月 术后4个月 左房前后径/mm 54 41 47 45 48 48 左室舒张末径/mm 42 40 42 44 50 47 二尖瓣位生物瓣前向流速a/(cm·s-1) 306 150 230 233 229 226 二尖瓣平均跨瓣压/mmHg 13 5 10 9 11 10 射血分数/% 61 59 56 58 58 69 瓣周漏 无 无 无 无 无 无 植入生物瓣功能 — 良好 良好 良好 良好 良好 瓣膜移位 — 无 无 无 无 无 
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[1] Balsam LB, Grossi EA, Greenhouse DG, et al. Reoperative valve surgery in the elderly: predictors of risk and long-term survival[J]. Ann Thorac Surg, 2010, 90(4): 1195-200;discussion 1201.
[2] Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?[J]. Eur Heart J, 2007, 28(11): 1358-1365. doi: 10.1093/eurheartj/ehm001
[3] Cerillo AG, Chiaramonti F, Murzi M, et al. Transcatheter valve in valve implantation for failed mitral and tricuspid bioprosthesis[J]. Catheter Cardiovasc Interv, 2011, 78(7): 987-995. doi: 10.1002/ccd.23112
[4] Alperi A, Garcia S, Rodés-Cabau J. Transcatheter valve-in-valve implantation in degenerated surgical aortic and mitral bioprosthesis: Current state and future perspectives[J]. Prog Cardiovasc Dis, 2021. http://www.sciencedirect.com/science/article/pii/S0033062021001080
[5] Zia Khan M, Zahid S, Khan MU, et al. Redo Surgical Mitral Valve Replacement Versus Transcatheter Mitral Valve in Valve From the National Inpatient Sample[J]. J Am Heart Assoc, 2021, 10(17): e020948. doi: 10.1161/JAHA.121.020948
[6] Goode D, Dhaliwal R, Mohammadi H. Transcatheter Mitral Valve Replacement: State of the Art[J]. Cardiovasc Eng Technol, 2020, 11(3): 229-253. doi: 10.1007/s13239-020-00460-4
[7] 金沁纯, 周达新. 二尖瓣介入治疗现状及新进展[J]. 中国医刊, 2022, 57(3): 248-251. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYI202203005.htm
[8] 赵玉玺, 鲍贤豪, 曾照祥, 等. 经导管二尖瓣置换术治疗二尖瓣反流研究进展[J]. 介入放射学杂志, 2019, 28(10): 1000-1004. https://www.cnki.com.cn/Article/CJFDTOTAL-JRFS201910020.htm
[9] Gallo M, Dvir D, Demertzis S, et al. Transcatheter valve-in-valve implantation for degenerated bioprosthetic aortic and mitral valves[J]. Expert Rev Med Devices, 2016, 13(8): 749-758. doi: 10.1080/17434440.2016.1207521
[10] Schaefer U, Conradi L, Lubos E, et al. First in human implantation of the mechanical expanding Lotus® valve in degenerated surgical valves in mitral position[J]. Catheter Cardiovasc Interv, 2015, 86(7): 1280-1286. doi: 10.1002/ccd.26162
[11] Biancari F, Rosato S, D'Errigo P, et al. Immediate and Intermediate Outcome After Transapical Versus Transfemoral Transcatheter Aortic Valve Replacement[J]. Am J Cardiol, 2016, 117(2): 245-251. doi: 10.1016/j.amjcard.2015.10.036
[12] Gada H, Kirtane AJ, Wang K, et al. Temporal Trends in Quality of Life Outcomes After Transapical Transcatheter Aortic Valve Replacement: A Placement of AoRTic TraNscathetER Valve(PARTNER)Trial Substudy[J]. Circ Cardiovasc Qual Outcomes, 2015, 8(4): 338-346. doi: 10.1161/CIRCOUTCOMES.114.001335
[13] Hensey M, Brown RA, Lal S, et al. Transcatheter Mitral Valve Replacement: An Update on Current Techniques, Technologies, and Future Directions[J]. JACC Cardiovasc Interv, 2021, 14(5): 489-500. doi: 10.1016/j.jcin.2020.12.038
[14] Beri N, Singh GD, Smith TW, et al. Iatrogenic atrial septal defect closure after transseptal mitral valve interventions: Indications and outcomes[J]. Catheter Cardiovasc Interv, 2019, 94(6): 829-836. doi: 10.1002/ccd.28294
[15] Rossi ML, Barbaro C, Pagnotta P, et al. Transapical transcatheter valve-in-valve replacement for deteriorated mitral valve bioprosthesis without radio-opaque indicators: the "invisible" mitral valve bioprosthesis[J]. Heart Lung Circ, 2015, 24(2): e19-22. doi: 10.1016/j.hlc.2014.09.016
[16] Yoon SH, Bleiziffer S, Latib A, et al. Predictors of Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve Replacement[J]. JACC Cardiovasc Interv, 2019, 12(2): 182-193. doi: 10.1016/j.jcin.2018.12.001
[17] Mankad SV, Aldea GS, Ho NM, et al. Transcatheter Mitral Valve Implantation in Degenerated Bioprosthetic Valves[J]. J Am Soc Echocardiogr, 2018, 31(8): 845-859. doi: 10.1016/j.echo.2018.03.008
[18] Reid A, Ben Zekry S, Turaga M, et al. Neo-LVOT and Transcatheter Mitral Valve Replacement: Expert Recommendations[J]. JACC Cardiovasc Imaging, 2021, 14(4): 854-866.
[19] 牛冠男, 宋光远, 吴永健. 经导管二尖瓣置换术在特殊类型二尖瓣疾病患者中的应用[J]. 中国介入心脏病学杂志, 2021, 29(8): 473-476. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXB202108010.htm
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