闵媛媛,徐承义,鄢华

• 1:武汉科技大学附属亚洲心脏病医院心内科
• 2:武汉科技大学医学部(医学院)

摘要(Abstract)：

急性缺血性二尖瓣反流是急性心肌梗死少见但致死率较高的机械性并发症。本病例报道1例急性下后壁心肌梗死合并急性重度缺血性二尖瓣反流及心源性休克的患者，在主动脉内球囊反搏支持下行直接经皮冠状动脉介入治疗（PPCI）完成血运重建，由于术后仍持续存在严重肺水肿及血流动力学不稳定，对机械循环支持依赖明显，经心脏团队评估后同期实施经导管二尖瓣缘对缘修复术（M-TEER）。术后二尖瓣反流由重度反流（4+）降至轻度反流（1+），肺水肿迅速改善，成功撤除机械通气及循环支持，患者顺利出院。该病例提示，对于严格筛选的高危急性心肌梗死合并急性二尖瓣反流患者，同期实施M-TEER可能有助于改善急性期血流动力学状态，其疗效与安全性仍需进一步研究证实。

关键词(KeyWords)： 直接经皮冠状动脉介入治疗;经导管二尖瓣缘对缘修复术;急性二尖瓣反流;急性心肌梗死;心源性休克;急性心力衰竭

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 闵媛媛,徐承义,鄢华

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