PDF(Pubmed)
Abstract：
UNASSIGNED: Marfan syndrome is an inherited disorder that manifests with various cardiovascular conditions. This case report discusses a patient with Marfan syndrome presenting with concurrent dissecting aortic aneurysm and acute mitral valve regurgitation (MR), exploring treatment strategies for this unique case.
UNASSIGNED: A 57-year-old man diagnosed with Marfan syndrome presented with progressive dyspnoea and awareness of orthopnoea. Acute heart failure (HF) due to acute MR associated with chordae rupture was diagnosed. However, contrast-enhanced CT revealed the coexistence of a massive dissecting aortic aneurysm, indicating surgical intervention. The dissecting aortic aneurysm extended over a large area. Given the high risk of simultaneous surgery with the mitral valve, a staged approach was adopted. Mitral valve transcatheter edge-to-edge repair (MV-TEER) was performed as the initial step to reduce the perioperative HF risk, followed by a planned two-stage surgery for the dissecting aortic aneurysm. This strategy effectively facilitated surgical intervention for the dissecting aortic aneurysm in the chronic phase after MV-TEER.
UNASSIGNED: Several reports showed the effectiveness of MV-TEER in cases of degenerative MR where surgical operation carries a high risk, but case report of MV-TEER in Marfan syndrome is rare. In recent years, the effectiveness of MV-TEER has also been reported as a \'bridge therapy\' for heart transplantation. Mitral valve transcatheter edge-to-edge repair is considered a potential option to serve as a bridge to other invasive intervention.
UNASSIGNED: A 57-year-old man diagnosed with Marfan syndrome presented with progressive dyspnoea and awareness of orthopnoea. Acute heart failure (HF) due to acute MR associated with chordae rupture was diagnosed. However, contrast-enhanced CT revealed the coexistence of a massive dissecting aortic aneurysm, indicating surgical intervention. The dissecting aortic aneurysm extended over a large area. Given the high risk of simultaneous surgery with the mitral valve, a staged approach was adopted. Mitral valve transcatheter edge-to-edge repair (MV-TEER) was performed as the initial step to reduce the perioperative HF risk, followed by a planned two-stage surgery for the dissecting aortic aneurysm. This strategy effectively facilitated surgical intervention for the dissecting aortic aneurysm in the chronic phase after MV-TEER.
UNASSIGNED: Several reports showed the effectiveness of MV-TEER in cases of degenerative MR where surgical operation carries a high risk, but case report of MV-TEER in Marfan syndrome is rare. In recent years, the effectiveness of MV-TEER has also been reported as a \'bridge therapy\' for heart transplantation. Mitral valve transcatheter edge-to-edge repair is considered a potential option to serve as a bridge to other invasive intervention.
摘要：
■马凡氏综合征是一种遗传性疾病，表现为各种心血管疾病。该病例报告讨论了一例Marfan综合征患者，并发夹层主动脉瘤和急性二尖瓣返流（MR），探索这一独特病例的治疗策略。
■一名57岁的男性被诊断为马凡氏综合征，表现为进行性呼吸困难和对正骨的认识。诊断为与腱索破裂相关的急性MR引起的急性心力衰竭（HF）。然而,增强CT显示大量夹层主动脉瘤共存，表明手术干预。夹层主动脉瘤扩展到大面积。考虑到二尖瓣同时手术的高风险，采取了分阶段的方法。二尖瓣经导管边缘对边缘修复术(MV-TEER)作为降低围手术期HF风险的初始步骤,随后是计划中的两个阶段的夹层主动脉瘤手术。该策略有效地促进了MV-TEER后慢性期夹层主动脉瘤的手术干预。
■一些报告显示，在外科手术高风险的退行性MR病例中，MV-TEER的有效性，但MV-TEER在马凡氏综合征中的病例报道很少。近年来,据报道,MV-TEER作为心脏移植的"桥接疗法"的有效性.二尖瓣经导管边缘到边缘修复被认为是其他侵入性干预的桥梁的潜在选择。
■一名57岁的男性被诊断为马凡氏综合征，表现为进行性呼吸困难和对正骨的认识。诊断为与腱索破裂相关的急性MR引起的急性心力衰竭（HF）。然而,增强CT显示大量夹层主动脉瘤共存，表明手术干预。夹层主动脉瘤扩展到大面积。考虑到二尖瓣同时手术的高风险，采取了分阶段的方法。二尖瓣经导管边缘对边缘修复术(MV-TEER)作为降低围手术期HF风险的初始步骤,随后是计划中的两个阶段的夹层主动脉瘤手术。该策略有效地促进了MV-TEER后慢性期夹层主动脉瘤的手术干预。
■一些报告显示，在外科手术高风险的退行性MR病例中，MV-TEER的有效性，但MV-TEER在马凡氏综合征中的病例报道很少。近年来,据报道,MV-TEER作为心脏移植的"桥接疗法"的有效性.二尖瓣经导管边缘到边缘修复被认为是其他侵入性干预的桥梁的潜在选择。
