主动脉瓣重度狭窄伴多脏器功能衰竭接受经导管主动脉瓣置换1例

Transcatheter aortic valve replacement for the treatment of severe aortic stenosis with multiple organ dysfunction:a case report

1病例资料患者,女,77岁,身高155 cm,体重35 kg,2017年5月因“反复胸闷、气急1年”就诊于复旦大学附属中山医院,心脏彩超示主动脉瓣增厚、钙化伴重度狭窄及中度反流,左室壁节段收缩异常,中度二、三尖瓣反流,重度肺动脉高压,肺动脉收缩压(pulmonary artery systolic pressure,PASP)91 mmHg(1 mmHg=0.133 kPa).患者及家属拒绝行主动脉瓣置换术,此后不规律服用托拉塞米、螺内酯、美托洛尔等治疗,胸闷、气急的症状反复发作。

Aortic stenosis(AS) is a common valvular heart disease in the elderly,which causes varying degrees of cardiac dysfunction and in severe cases can be life-threatening.Transcatheter aortic valve replacement(TAVR) has been proved relatively safe and effective in severe AS patients at intermediate-to-high risk who are considered as contraindication for surgery.We report a case of successful TAVR treatment in patient with extremely high risk of mortality due to severe aortic stenosis and multiple organ dysfunction.