二叶式主动脉瓣经导管主动脉瓣置换术中瓣膜脱入升主动脉1例

A case report:valve protruding into ascending aorta during transcatheter aortic valve replacement with bicuspid aortic valve

1病例资料患者,男性,77岁,因"活动后胸闷气喘1个月余,加重1d"入院。既往有高血压、糖尿病、冠心病、陈旧性前壁心肌梗死、肺栓塞、脑出血病史。入院体检:体温36.3℃,脉搏80次/min,呼吸22次/min,血压130/85mmHg(1mmHg=0.133kPa),神志清楚,精神萎靡;颈静脉充盈;双肺呼吸音粗。

Transcatheter aortic valve replacement(TAVR)has gradually become an important treatment for patients with high,medium,or even low risk of severe aortic valve stenosis(AS).However,due to the geometric abnormality of the valve,patients with bicuspid aortic valve(BAV)have been excluded from many TAVR tests.At present,it is listed as a relative indication in domestic and foreign guidelines.However,domestic BAV accounts for 40%-50%of all AS patients.Therefore,the application of TAVR in BAV patients has greater clinical significance in our country.This paper reports a case of BAV complicated with severe AS with calcification.The valve upward movement during TAVR resulted in severe perivalvular leakage.The operation was completed successfully by emergency use of the valvular technique.