背景:在获得替代二尖瓣后,机械瓣膜的完全移位作为长期问题极为罕见,这份报告详细介绍了机械阀门完全脱离的事件。
方法:一个50岁的女人,20年前在另一家医院接受了二尖瓣机械瓣膜置换术,因突然心源性休克而紧急入院。
方法:经胸超声心动图显示二尖瓣假体严重故障,以显著的二尖瓣反流和中度肺动脉高压为特征。在插入体外膜氧合和主动脉内球囊泵后,血流动力学稳定了.冠状动脉造影显示左心房内漂浮的人工二尖瓣环和小叶,经术前实时三维经食管超声心动图证实。观察到假体环和小叶与缝合环完全分离。
方法:患者迅速接受了生物二尖瓣置换术。
结果:患者术后进展顺利,导致排放状况良好。
结论:一个关键方面是理解人工瓣膜本身的结构。经胸超声心动图和实时三维经食管超声心动图的使用提供了额外的结构和功能细节,加强对潜在救生干预措施的支持。超声心动图在评估人工瓣膜的形态和功能方面起着重要作用。
BACKGROUND: Complete dislodgement of a mechanical valve is extremely uncommon as a long-term issue after getting a substitute mitral valve, and this report details an incident of complete detachment of a mechanical valve.
METHODS: A 50-year-old woman, who underwent mitral mechanical valve replacement 2 decades earlier at another facility, was urgently admitted due to sudden cardiogenic shock.
METHODS: Transthoracic echocardiograms revealed severe malfunction of the mitral valve prosthesis, characterized by significant mitral regurgitation and moderate pulmonary hypertension. Following the insertion of extracorporeal membrane oxygenation and an intra-aortic balloon pump, the hemodynamics stabilized. Coronary angiography displayed the prosthetic mitral valve ring and leaflet floating in the left atrium, as confirmed by preoperative real-time 3-dimensional transesophageal echocardiography. A complete separation of the prosthetic ring and leaflet from the suture ring was observed.
METHODS: The patient promptly underwent bioprosthetic mitral valve replacement.
RESULTS: The patient\'s postoperative course was uneventful, leading to discharge in good condition.
CONCLUSIONS: A crucial aspect is comprehending the structure of the prosthetic valve itself. The use of transthoracic echocardiography and real-time 3-dimensional transesophageal echocardiography provides additional structural and functional details, enhancing support for potential life-saving interventions. Echocardiography plays a significant role in evaluating the morphology and function of prosthetic valves.