Successful Multidisciplinary Treatment in a Patient With Severe Aortic Valve Stenosis and Hypertrophic Obstructive Cardiomyopathy
10.3969/j.issn.1000-3614.2023.12.011
- VernacularTitle:重度主动脉瓣狭窄合并肥厚型梗阻性心肌病一例
- Author:
Liang WANG
1
;
Liming GAO
;
Jing HUANG
;
Qi ZHANG
Author Information
1. 同济大学附属东方医院 心血管内科,上海 200120
- Keywords:
aortic valve stenosis;
hypertrophic obstructive cardiomyopathy;
ventricular septal ablation;
microspheres embolism;
transcatheter aortic valve replacement
- From:
Chinese Circulation Journal
2023;38(12):1297-1301
- CountryChina
- Language:Chinese
-
Abstract:
Surgical treatment is the first choice for patients with aortic stenosis(AS)and hypertrophic obstructive cardiomyopathy(HOCM),this article reports a case of a high-risk surgical patient who underwent transcatheter aortic valve replacement(TAVR)after undergoing percutaneous septal embolization with microspheres(PSEM)to treat left ventricular outflow tract(LVOT)obstruction.A 77-year-old male patient was admitted due to chest tightness and shortness of breath post physical activities.Echocardiography showed signs of severe aortic valve stenosis(mean gradient:53 mmHg)and HOCM(peak LVOT gradient:93 mmHg).The risk of cardiac surgery is extremely high.Multidisciplinary decision was reached in that PSEM strategy should be performed at first to relieve LVOT obstruction,followed by TAVR to treat aortic valve stenosis.After embolization of the first septal branch with microparticles,the peak LVOT gradient decreased to 15 mmHg immediately post PSEM.TAVR was performed at 6 days post PSEM,the postoperative aortic valve pressure gradient decreased to 2 mmHg.The patient was discharged without complications.
