Christina Mew MBBS, FRACP, Arun Dahiya MBBS, MPhil, FRACP, FCSANZ, Adrian A. Chong MBBS, FRACP, FCSANZ, Samual M. Hayman MBBS, MSc, FRACP, FCSANZ, Peter T. Moore MBBS, FRACP, FCSANZ, Danielle L. Harrop MBBS, FRACP, FCSANZ, Reza Reyaldeen MBBS, FRACP, FCSANZ, Christopher M. W. Cole MBBS, FRACS, FCSANZ, Jordan D. W. Ross MBBS, FRACS, FCSANZ, Shaun Roberts MBBS, FRANZCA, Kellee A. Korver BN, Stephen V. Cox MBBS, FRACP, FCSANZ, Anthony C. Camuglia MBBS, (Hons1, Monash), MHA, (Monash), FRACP, FCSANZ
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引用次数: 0
摘要
冠状动脉阻塞(CO)是经导管主动脉瓣置换术(TAVR)的潜在隐患,尤其是在将瓣膜置入退化的外科或经导管人工瓣膜的手术中。结合电外科手术的生物人工瓣叶修整技术正逐渐成为在高CO风险情况下降低CO风险的首选策略。UNICORN 方法是一种比早期描述的 BASILICA 方法更可预测的瓣叶修整策略,但其支持者迄今为止一直强制要求使用球囊扩张瓣(BEV)假体。许多患者的假体较小,在这种情况下使用 BEV 会面临假体不匹配的巨大风险。如果能使用自膨胀瓣膜(SEV)假体,则可降低这种风险。本文介绍的是一种经过改进的方法,可在这种情况下使用 SEV 系统。
First-in-human: Leaflet laceration with balloon mediated annihilation to prevent coronary obstruction with radiofrequency needle (LLAMACORN) for valve-in-valve transcatheter aortic valve replacement
Coronary obstruction (CO) is a potential pitfall for transcatheter aortic valve replacement (TAVR), especially in valve in valve procedures into degenerated surgical or transcatheter prostheses. Bioprosthetic leaflet modification techniques that incorporate electrosurgery are evolving as the preferred strategy to mitigate the risk of CO in high CO risk settings. The UNICORN method is proposed as a more predictable leaflet modification strategy than the earlier described BASILICA approach, but its proponents have hitherto mandated the use of a balloon-expandable valve (BEV) prosthesis. Many patients have small prostheses and therein face a significant risk of patient prosthesis mismatch with BEV in this setting. This risk may be curtailed if a self-expanding valve (SEV) prosthesis could be used. Herein described is a modified approach to allow for the utilization of SEV systems in this setting.
期刊介绍:
Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.