外科术后瓣周漏病例封堵术王广义课件

Case report:Case report: 外科术后瓣周漏病例外科术后瓣周漏病例-封堵术封堵术? ? Transcatheter closure of heart Paravalvular or perivalvular leaks postoperationTranscatheter closure of heart Paravalvular or perivalvular leaks postoperation Guang-yi WANG (Guang-yi WANG (王广义；王广义；王峙峰；候海军王峙峰；候海军 冯冯 斌等斌等 ) ) Department of Cardiology, Department of Cardiology, Chinese PLA General Hospital, Chinese PLA General Hospital, Beijing 100853, CHINA Beijing 100853, CHINA 中国人民解放军总医院中国人民解放军总医院 1 Pvl is the common after Valve 1 Pvl is the common after Valve replacement and repair surgeryreplacement and repair surgery Chinese PLA General Hospital Medical therapyMedical therapy is palliative is palliative Reoperation Reoperation carries significant morbidity and carries significant morbidity and Mortality.Mortality. Percutaneous transcatheter closurePercutaneous transcatheter closure techniques, now routinely applied in techniques, now routinely applied in the management of pathological cardiac and the management of pathological cardiac and vascular communications, may be Adaptable vascular communications, may be Adaptable to PVL closure, potentially offer symptomatic to PVL closure, potentially offer symptomatic relief.relief. Chinese PLA General Hospital 2. Classification of 2. Classification of paravalvular paravalvular or perivalvular leaksor perivalvular leaks 1.1.Mechanical prosthesesMechanical prostheses AorticAortic Mitral Mitral 2.2. BioprosthesesBioprostheses 3. Valved stent3. Valved stent Chinese PLA General Hospital * * Transcatheter closure of Transcatheter closure of prosthetic paravalvular leaksprosthetic paravalvular leaks p aravalvular leaks after heart prosthetic aravalvular leaks after heart prosthetic valve replacementvalve replacement Chinese PLA General Hospital Antegrade transseptal approach Retrograde transarterial approach Femoral veinFemoral veinright atriumright atrium puncture atrial septalpuncture atrial septalleft left atriumatriumleft ventricleleft ventricleaortaaorta femoral artery steel wire trackfemoral artery steel wire track Chinese PLA General Hospital Interventional procedure： 1. 2. Femoral arteryFemoral arteryaortaleft aortaleft ventricleventricle Devices of paravalvular leaks 1.rashkind Clamshell CardioSEAL STARFlex 2.coil 3.pfm coil 5.PDA device 6.ASD device 7.VSD device Chinese PLA General Hospital Case 1.Case 1. aorta paravalvular leak aorta paravalvular leak Chinese PLA General Hospital 2. mitral paravalvular leak due to Mechanical prostheses Valve replacement Mitral PVLsMitral PVLs Case1. female, 36 yrs, 3 years LV dysfunction after mitral prostheses Valve Replacement. Chinese PLA General Hospital Chinese PLA General Hospital 徐 xx F 56y,二尖瓣单叶瓣机械瓣 Chinese PLA Gen