Öz
Giriş: Protez kapağı olup dekompanse kalp yetersizliği kliniği ile
başvuran olgular, acil servislerde hem tanı hem de tedavi açısından
zorlu bir grubu oluşturmaktadırlar. Bu hasta grubunda kapak
fonksiyonlarının gösterilmesinde transtorasik ekokardiyografinin
önemli rolü olsa da, yetersiz kaldığı durumlar sıktır.
Olgu Sunumu: Dekompanse kalp yetersizliği ile başvuran
atmışbeş yaşındaki bayan hastanın 6 yıl önce mitral ve aortik kapak
replasmanı hikayesi olduğu öğrenilmiştir. Kapak fonksiyonlarının
değerlendirilmesinde transtorasik ekokardiyogafinin yeterli
sonuç vermediği olgumuzda, floro-skopi cihazı kullanılarak kapak
disfonksiyonuna başarılı bir şekilde tanı koyulabilmiştir.
Sonuç: Transtorasik ekokardiyografiye erişim sağlanamadığı veya
yetersiz olduğu durumlarda, kapak disfonksiyonu ayırıcı tanısında
ilk görüntüleme yöntemi olarak floro-skopi kullanılması pratik ve
kesin bir yöntemdir.
Anahtar Kelimeler
Kaynakça
- Roudaut R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart (British Cardiac Society) 2007; 93: 137-42. [CrossRef]
- Teshima H, Hayashida N, Yano H, Nishimi M, Tayama E, Fukunaga S, et al. Obstruction of st jude medical valves in the aortic position: histology and immunohistochemistry of pannus. J Thorac Cardiovasc Surg 2003; 126: 401-7. [CrossRef]
- Ellensen VS, Andersen KS, Vitale N, Davidsen ES, Segadal L, Haaverstad R. Acute Obstruction by Pannus in Patients With Aortic MedtronicHall Valves: 30 years of Experience. Ann Thorac Surg 2013; 96: 2123-8. [CrossRef]
- Montorsi P, De Bernardi F, Muratori M, Cavoretto D, Pepi M. Role of cinefluoroscopy, transthoracic, and transesophageal echocardiography in patients with suspected prosthetic heart valve thrombosis. Am J Cardiol 2000; 85: 58-64. [CrossRef]
- Neragi-Miandoab S, Westbrook B, Flynn J, Blakely J, Baribeau Y. Prosthetic Valve Endocarditis Five Months following Transcatheter Aortic Valve Implantation and Review of Literature. Heart Surg Forum 2015; 18: E020-2. [CrossRef]
- Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al; ESC Committee for Practice Guidelines (CPG); Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012; 42: S1-44. [CrossRef]
A Case of Decompensated Heart Failure Due to Prosthetic Valve Dysfunction: Quick Diagnosis with Fluoroscopy
Öz
Introduction: Patients with decompensated heart failure due to prosthetic heart valves consists of a challenging group in emergency clinics for both diagnosis and treatment. Despite the important role in diagnosis, transthoracic echocardiography (TTE) remains unsatisfactory in many cases. Case Report: A 65-year-old female patient with decompensated heart failure and a history of valve replacement surgery 6 years ago for both mitral and aortic valves was admitted. The diagnosis of prosthetic valve dysfunction was successfully fixed using fluoroscopy, despite the fact that initial TTE was not adequate enough to assess valve function. Conclusion: In cases that TTE is not accessible or inadequate enough to assess valve function, fluoroscopy is a practical and quick method to rule out prosthetic valve dysfunction
Anahtar Kelimeler
Kaynakça
- Roudaut R, Serri K, Lafitte S. Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. Heart (British Cardiac Society) 2007; 93: 137-42. [CrossRef]
- Teshima H, Hayashida N, Yano H, Nishimi M, Tayama E, Fukunaga S, et al. Obstruction of st jude medical valves in the aortic position: histology and immunohistochemistry of pannus. J Thorac Cardiovasc Surg 2003; 126: 401-7. [CrossRef]
- Ellensen VS, Andersen KS, Vitale N, Davidsen ES, Segadal L, Haaverstad R. Acute Obstruction by Pannus in Patients With Aortic MedtronicHall Valves: 30 years of Experience. Ann Thorac Surg 2013; 96: 2123-8. [CrossRef]
- Montorsi P, De Bernardi F, Muratori M, Cavoretto D, Pepi M. Role of cinefluoroscopy, transthoracic, and transesophageal echocardiography in patients with suspected prosthetic heart valve thrombosis. Am J Cardiol 2000; 85: 58-64. [CrossRef]
- Neragi-Miandoab S, Westbrook B, Flynn J, Blakely J, Baribeau Y. Prosthetic Valve Endocarditis Five Months following Transcatheter Aortic Valve Implantation and Review of Literature. Heart Surg Forum 2015; 18: E020-2. [CrossRef]
- Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al; ESC Committee for Practice Guidelines (CPG); Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012; 42: S1-44. [CrossRef]
Ayrıntılar
| Diğer ID | JA43FM84PF |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2015 |
| Gönderilme Tarihi | 1 Temmuz 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 6 Sayı: 3 |