PDF(Pubmed)
Abstract：
UNASSIGNED: Transcatheter edge-to-edge repair (TEER) for the systemic atrioventricular valve has been anecdotally reported as a viable treatment option in symptomatic inoperable adult patients born with congenitally corrected transposition of the great arteries (ccTGA). However, to date, case reports on TEER treatment of both atrioventricular valves are lacking, especially when considering the present availability of specific mitral and tricuspid valve TEER devices.
UNASSIGNED: We present the case of an 84-year-old man with recurrent admissions for acute heart failure due to high-grade regurgitation of both atrioventricular valves. The patient was first diagnosed with ccTGA at this advanced age and underwent a thorough multimodality imaging approach, including transthoracic and transoesophageal echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, and ventriculography of the systemic ventricle. Due to the high symptom burden despite optimal medical therapy and high doses of diuretics, the heart team recommended TEER, first for the systemic tricuspid valve and later on for the non-systemic mitral valve. Both complex procedures were uneventful and led to considerable improvement in quality of life.
UNASSIGNED: Congenitally corrected transposition of the great arteries mostly manifests itself in adulthood and affects both ventricles and atrioventricular valves. In case of anatomical doubts on transthoracic echocardiography, a thorough multimodality imaging work-up is recommended. Transcatheter treatment of both atrioventricular valves seems to be a safe and effective therapeutic option in these often inoperable patients.
UNASSIGNED: We present the case of an 84-year-old man with recurrent admissions for acute heart failure due to high-grade regurgitation of both atrioventricular valves. The patient was first diagnosed with ccTGA at this advanced age and underwent a thorough multimodality imaging approach, including transthoracic and transoesophageal echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, and ventriculography of the systemic ventricle. Due to the high symptom burden despite optimal medical therapy and high doses of diuretics, the heart team recommended TEER, first for the systemic tricuspid valve and later on for the non-systemic mitral valve. Both complex procedures were uneventful and led to considerable improvement in quality of life.
UNASSIGNED: Congenitally corrected transposition of the great arteries mostly manifests itself in adulthood and affects both ventricles and atrioventricular valves. In case of anatomical doubts on transthoracic echocardiography, a thorough multimodality imaging work-up is recommended. Transcatheter treatment of both atrioventricular valves seems to be a safe and effective therapeutic option in these often inoperable patients.
摘要：
■据传闻，全身性房室瓣的经导管边缘到边缘修复（TEER）是一种可行的治疗选择，适用于先天性矫正大动脉转位的有症状的不能手术的成年患者（ccTGA）。然而,到目前为止,缺乏TEER治疗两个房室瓣的病例报告，特别是考虑到目前特定二尖瓣和三尖瓣TEER装置的可用性。
■我们介绍了一例84岁男性因两个房室瓣高度反流导致急性心力衰竭反复入院的病例。患者在这个高龄时首次被诊断为ccTGA，并接受了彻底的多模态成像方法，包括经胸和经食道超声心动图，心脏磁共振成像，心脏计算机断层扫描,和全身心室的心室造影。由于高的症状负担，尽管最佳的药物治疗和高剂量的利尿剂，心脏团队推荐TEER,首先是全身性三尖瓣，然后是非全身性二尖瓣。两种复杂的程序都很顺利，并导致生活质量的显着改善。
■先天性矫正的大动脉转位主要表现在成年期，并影响心室和房室瓣。如果对经胸超声心动图有解剖学怀疑，建议进行彻底的多模态成像检查.在这些通常无法手术的患者中，经导管治疗两个房室瓣似乎是安全有效的治疗选择。
■我们介绍了一例84岁男性因两个房室瓣高度反流导致急性心力衰竭反复入院的病例。患者在这个高龄时首次被诊断为ccTGA，并接受了彻底的多模态成像方法，包括经胸和经食道超声心动图，心脏磁共振成像，心脏计算机断层扫描,和全身心室的心室造影。由于高的症状负担，尽管最佳的药物治疗和高剂量的利尿剂，心脏团队推荐TEER,首先是全身性三尖瓣，然后是非全身性二尖瓣。两种复杂的程序都很顺利，并导致生活质量的显着改善。
■先天性矫正的大动脉转位主要表现在成年期，并影响心室和房室瓣。如果对经胸超声心动图有解剖学怀疑，建议进行彻底的多模态成像检查.在这些通常无法手术的患者中，经导管治疗两个房室瓣似乎是安全有效的治疗选择。
