A novel approach to percutaneous removal of large tricuspid valve vegetations using suction filtration and veno-venous bypass: A single center experience
A novel approach to percutaneous removal of large tricuspid valve vegetations using suction filtration and veno-venous bypass: A single center experience
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DOI：
10.1002/ccd.27097
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发表时间：
2017-11-15
影响因子：
2.3
通讯作者：
Gurley, John
中科院分区：
文献类型：
--
作者：
George, Bennet;Voelkel, Anthony;Gurley, John
背景三尖瓣手术已成为药物治疗无效的三尖瓣心内膜炎（TVE）的标准治疗方法。现在可以使用带有体外旁路回路的静脉引流插管经皮去除右侧赘生物。目的我们研究的目的是描述我们的单一-方法我们回顾了33例具有高手术风险的三尖瓣赘生物患者的围手术期过程。40个月，平均年龄37岁。绝大多数患者（72.7%）被确诊或确诊为注射吸毒。术前平均赘生物尺寸为2.1 +/- 0.7 cm，术后尺寸减小61%。所有患者均在手术中存活，90.9%的患者在首次住院后存活。三例患者进行了择期三尖瓣置换术，由于恶化的严重程度的三尖瓣reflect.ConclusionPercutaneous去除大三尖瓣赘生物是一种安全有效的选择TVE患者进行高手术风险。(c)2017 Wiley Periodicals，Inc.
BackgroundTricuspid valve surgery has been the de facto standard treatment for tricuspid valve endocarditis (TVE) refractory to medical therapy. It is now possible to remove right-sided vegetations percutaneously using a venous drainage cannula with an extracorporeal bypass circuit.ObjectivesThe purpose of our study is to describe our single-center experience of percutaneous tricuspid valve vegetation removal.MethodsWe reviewed the perioperative course of 33 consecutive patients with large tricuspid valve vegetations who carried high surgical risk.ResultsThe cohort included 12 males and 21 females over a 40-month period with an average age of 37 years. A preponderance of patients carried an admitted or confirmed diagnosis of injection drug use (72.7%). Average vegetation size was 2.1 +/- 0.7 cm prior to the procedure with a 61% reduction in size after the procedure. All patients survived the procedure and 90.9% survived the index hospitalization. Three patients proceeded to elective tricuspid valve replacement due to worsening severity of tricuspid regurgitation.ConclusionPercutaneous removal of large tricuspid valve vegetations is a safe and effective alternative for patients with TVE who carry high-surgical risk. (c) 2017 Wiley Periodicals, Inc.