应用K-Clip系统经导管治疗左心瓣膜置换术后重度三尖瓣反流1例A case of transcatheter treatment of severe tricuspid regurgitation using the K-clip device after left mechanical valve replacement
郑帆,张晓春,陈莎莎,李明飞,李伟,潘翠珍,郭克芳,潘文志,周达新,葛均波
摘要(Abstract):
本文报告1例应用K-Clip系统经颈静脉路径进行三尖瓣瓣环修复治疗的左心机械瓣置换术后重度三尖瓣反流(TR)患者,经术前超声心动图、三维CT重建评估,在数字减影血管造影(DSA)、经食管超声心动图(TEE)引导下全身麻醉行介入三尖瓣瓣环修复,术后TR减轻,术后1个月随访TR较术后减轻,右心房缩小,症状明显好转。提示应用K-Clip系统是该类患者的有效治疗方式。
关键词(KeyWords): 经导管三尖瓣瓣环修复;三尖瓣反流;机械瓣置换术
基金项目(Foundation): 国家重点研发计划资助项目(2020YFC2008104)
作者(Author): 郑帆,张晓春,陈莎莎,李明飞,李伟,潘翠珍,郭克芳,潘文志,周达新,葛均波
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