国际麻醉学与复苏杂志   2023, Issue (6): 0-0
    
主动脉瓣狭窄合并主动脉缩窄一期介入修复麻醉管理1例
张凯文, 李美红, 姚文龙, 曾和松, 万里1()
1.华中科技大学同济医学院附属同济医院麻醉科
Anesthesia management of simultaneous transcatheter intervention for aortic stenosis and coarctation of the aorta: one case report
 全文:
摘要：

主动脉瓣狭窄（aortic stenosis, AS）是一种较常见的心脏瓣膜病变，而合并主动脉缩窄（coarctation of the aorta, CoA）十分罕见，发病率<1%。近年来覆膜支架置入已被广泛用于治疗CoA，而经导管主动脉瓣置换术（transcatheter aortic valve replacement, TAVR）作为介入新技术也逐渐在临床推广应用，但是同时经导管介入治疗CoA和AS在国内经验尚少，这对手术医师和麻醉医师来说均是一个巨大挑战。报道1例“一站式”经股动脉置入支架治疗CoA、经颈动脉TAVR治疗AS的成功病例，术后主动脉内压力阶差基本消失且未出现反流。
关键词： 主动脉缩窄； 主动脉瓣狭窄； 覆膜支架； 经导管主动脉瓣置换术； 麻醉管理
Abstract:

Aortic stenosis (AS) is a common heart valve degeneration, while AS patients with coarctation of the aorta (CoA) are rare, with an incidence of less than 1%. In recent years, cheatham‑platinum stent implantation has widely used for the treatment of CoA, while transcatheter aortic valve replacement (TAVR) is also increasing applied as a new invention technique in clinical practice. However, there is little experience in the treatment of CoA and AS by transcatheter intervention in China, and pose a great challenge for surgeons and anesthetists. In the current report, a successful case of cheatham‑platinum stent implantation via the femoral artery for CoA and TAVR via the carotid artery for AS was analyzed. After deployment of the stent graft and valve, there was no significant pressure gradient within the aorta, without aortic regurgitation.
Key words: Coarctation of the aorta; Aortic stenosis; Cheatham‑platinum stent; Transcatheter aortic valve replacement; Anesthesia management