经导管主动脉瓣置换术中应用颈动脉滤器1例Application of carotid fi lter in transcatheter aortic valve replacement: a case report
刘先宝,戴晗怡,王力涵,裘敏剑,郭宇超,范嘉祺,阿不都吾甫尔·依迪力斯,朱钢杰,周道,王建安
摘要(Abstract):
经导管主动脉瓣置换术(TAVR)为治疗症状性主动脉瓣狭窄的一线治疗手段。即使瓣膜技术不断发展及脑保护装置种类增多,卒中仍是TAVR术后常见且破坏性极大的并发症之一,其发生与手术操作密切相关。本文报道了术前超声心动图提示左心室流出道内飘带样回声,行TAVR时应用颈动脉滤器的病例1例,旨在为卒中高危患者行TAVR制订手术策略时提供新的思路。
关键词(KeyWords): 经导管主动脉瓣置换术;卒中;颈动脉滤器
基金项目(Foundation):
作者(Author): 刘先宝,戴晗怡,王力涵,裘敏剑,郭宇超,范嘉祺,阿不都吾甫尔·依迪力斯,朱钢杰,周道,王建安
参考文献(References):
- [1] Bates ER. Treatment options in severe aortic stenosis[J].Circulation, 2011, 124(3):355-359.
- [2] Leon MB, Smith CR, Mack M, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery[J]. N Engl J Med, 2010, 363(17):1597-1607.
- [3] Voss S, Deutsch M-A, Schechtl J, et al. Impact of a two-filter cerebral embolic protection device on the complexity and risk of transcatheter aortic valve replacement[J]. Thorac Cardiovasc Surg,2020, 68(7):616-622.
- [4] Seeger J, Virmani R, Romero M,et al. Signifi cant diff erences in debris captured by the sentinel dual-fi lter cerebral embolic protection during transcatheter aortic valve replacement among diff erent valve types[J]. JACC Cardiovasc Interv, 2018, 11(17):1683-1693.
- [5] Nombela-Franco L, Webb JG, de Jaegere PP, et al. Timing,predictive factors, and prognostic value of cerebrovascular events in a large cohort of patients undergoing transcatheter aortic valve implantation[J]. Circulation, 2012, 126(25):3041-3053.
- [6] Haussig S, Mangner N, Dwyer MG, et al. Effect of a cerebral protection device on brain lesions following transcatheter aortic valve implantation in patients with severe aortic stenosis:the CLEANTAVI randomized clinical trial[J]. JAMA, 2016, 316(6):592-601.
- [7] Kapadia SR, Kodali S, Makkar R, et al. Protection against cerebral embolism during transcatheter aortic valve replacement[J]. J Am Coll Cardiol, 2017, 69(4):367-377.
- [8] Pollari F, Hitzl W, Vogt F, et al. Aortic valve calcification as a risk factor for major complications and reduced survival after transcatheter replacement[J]. J Cardiovasc Comput Tomogr, 2020,14(4):307-313.