PMVR後の多弁膜症における二重心エコー検査?

Duplex Echocardiography in multivalvular Heart Disease after PMVR?

• Lisa Dannenberg
• Shazia Afzal
• Shqipe Gerguri
• Kerstin Piayda
• Malte Kelm
• Tobias Zeus
• Amin Polzin
• Verena Veulemans

抄録

Edenらは、経皮的僧帽弁修復術（PMVR）を行っても、心房中隔欠損症（iASD）や右室過負荷は生じないことを示した。このことは、6ヶ月後の追跡調査時に心エコー検査で評価された右室機能と同様に、術中に全身血流と肺血流によって測定された。PMVR後の心房シャントの発生率は、心房内穿刺を必要とする他の手技と同程度である。しかし、血行動態の変化が原因でiASDの緊急閉鎖が必要な症例も報告されている。当科では85歳の男性が心不全による呼吸困難と腹痛を訴えた。

Eden et al. were able to show that percutaneous mitral valve repair (PMVR) procedure does not lead to relevant iatrogenic atrial septal defect (iASD) or right ventricular overload. This was measured intra-procedurally by systemic and pulmonary flow as well as by right ventricular function at six month follow-up assessed by echocardiography. Rate of atrial shunt after PMVR is comparable with other procedures requiring intra-atrial punctuation . However, some cases have been reported with the need for urgent closure of the iASD because of relevant hemodynamic alterations. In our department, an 85-year old man recently presented with dyspnea and abdominal pain due to cardiac decompensation.

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