经颈动脉途径经导管主动脉瓣置换术治疗重度主动脉瓣狭窄一例

Transcatheter aortic valve replacement for severe aortic valve stenosis via carotid approach:a case report

该病例为有症状的主动脉瓣钙化伴重度主动脉瓣狭窄的老年男性患者,术前心脏瓣膜团队已充分评估患者是否适合经导管主动脉瓣置换术及其入路。该病例的髂动脉、股动脉、降主动脉等有多处重度狭窄、斑块,故选择颈动脉入路经导管主动脉瓣置换术。术后患者症状明显改善,随访至今,一般状况良好,日常活动无胸闷、气短等症状。目前临床上经颈动脉入路应用相对较少,但相信随着更多临床研究结果的公布,经颈动脉入路在经导管主动脉瓣置换术中的应用会越来越普遍。

This case was an elderly male patient with symptomatic aortic valve calcification and severe aortic valve stenosis.Before the operation,the heart valve team had fully evaluated the patient’s suitability for transcatheter aortic valve replacement and approach.This patient had severe stenosis and plaques in the iliac artery,femoral artery,descending aorta,so the carotid artery approach transcatheter aortic valve replacement was chosen.After the operation,the patient’s symptoms improved significantly.So far,the patient was generally in good condition,without chest tightness,shortness of breath and other symptoms in daily activities.The current clinical application of the transcarotid approach is relatively small,but it is believed that with the publication of more clinical research results,the application of the transcarotid approach in transcatheter aortic valve replacement will become more and more common.