Sol atriyal apendikste trombüsü olan bir hastada kapak içine kapak işlemi ile aort kapak replasmanı

Son yıllarda transkateter aort kapak replasmanı için uygun olan hastaların endikasyonları ve yaş aralığı giderek genişlemektedir. Transkateter aort kapak replasmanının uygulandığı birçok çalışmada sol atriyal apendikste trombüs varlığı bir dışlanma kriteridir. Seksen altı yaşında erkek hasta, 14 yıl önce implante edilen 22 mm'lik bir biyoprotez kapağın dejenerasyonuna bağlı semptomatik ciddi aort darlığı ile başvurdu. Transözofageal ekokardiyografide sol atriyal apendikste trombüs görüldü ve kontrastlı bilgisayarlı tomografi ile doğrulandı. Balon ile genişleyen kapak, dejenere olmuş aort biyoprotezine başarıyla yerleştirildi. Sonuç olarak, sol atriyal apendikste trombüsü olan bir hastada kapak içine kapak yöntemi ile transkateter aort kapak replasmanının yapılabileceğini göstermeyi amaçladık.

Aortic valve replacement using valve-in-valve procedure in a patient with left atrial appendage thrombus

In recent years, indications and age range of patients who areeligible for transcatheter aortic valve replacement have beenincreasingly extended. The presence of a thrombus in the leftatrial appendage is an exclusion criterion in many studies usingtranscatheter aortic valve replacement. An 86-year-old malepatient was admitted with symptomatic severe aortic stenosissecondary to degeneration of a 22-mm bioprosthetic valveimplanted 14 years ago. Transesophageal echocardiographyrevealed a thrombus in the left atrial appendage and it wasconfirmed by contrast-enhanced computed tomography. Theballoon-expandable valve was successfully implanted into thedegenerated aortic bioprosthesis. In conclusion, we aimed to showthat valve-in-valve transcatheter aortic valve replacement can beperformed in a patient with thrombus in the left atrial appendage.

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