二尖瓣后叶悬垂:经皮二尖瓣手术罕见但可能出现的并发症。

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Revascularization Medicine Pub Date : 2024-10-15 DOI:10.1016/j.carrev.2024.09.017
Francesca Napoli, Ciro Vella, Vittorio Romano, Luca Ferri, Marco B Ancona, Barbara Bellini, Filippo Russo, Eustachio Agricola, Antonio Esposito, Matteo Montorfano
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引用次数: 0

摘要

二尖瓣反流的两种手术方案是置换和修复,其中瓣环成形术是矫正的基础。在修复失败的情况下,尤其是手术风险较高的患者,经导管二尖瓣环内成形术(MViR)是新出现的具有挑战性的选择。在与这种治疗方法相关的几种并发症中,本文深入探讨了在 MViR 手术中,原生二尖瓣叶在引发急性生物假体功能障碍方面可能扮演的角色。文献广泛报道了与前叶有关的并发症,包括流出道梗阻和由于本体二尖瓣叶和人工二尖瓣叶相互作用导致的残余二尖瓣关闭不全等风险。相反,人们对涉及后叶的并发症了解较少,而且经常忽视。针对这一文献空白,我们介绍了一个临床病例,强调了多余的原生二尖瓣后叶如何通过干扰人工二尖瓣叶意外导致急性严重二尖瓣关闭不全。
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The posterior mitral leaflet overhang: A rare yet possible complication of percutaneous mitral valve procedures.

The two surgical options for mitral valve regurgitation are replacement and repair, with annuloplasty being the cornerstone of correction. In cases of repair failure, especially in high surgical risk patients, transcatheter mitral valve-in-ring (MViR) procedures represent emerging and challenging options. Among the several complications linked to this treatment, this paper delves into the role that native mitral leaflets may play in precipitating acute bioprosthesis dysfunction in the MViR procedure. The literature extensively covers complications related to the anterior leaflet, including risks such as outflow tract obstruction and residual mitral insufficiency due to interaction between native and prosthetic leaflets. Conversely, complications involving the posterior leaflet are less understood and often overlooked. In this gap in the literature, we present a clinical case highlighting how a redundant native posterior mitral leaflet can unexpectedly lead to acute severe mitral insufficiency by interfering with prosthetic leaflets.

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来源期刊
Cardiovascular Revascularization Medicine
Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.90%
发文量
687
审稿时长
36 days
期刊介绍: Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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