양측 장골동맥협착을 동반한 환자에서 경대퇴동맥 접근법을 통한 경피적 대동맥판막 삽입술 = Transcatheter Aortic Valve Implantation by Transfemoral Approach in a Patient with Bilateral Iliac Artery Disease

국문 초록 (Abstract)

본 환자는 수술의 고위험군인 중증 대동맥판협착 환자이며 TAVI를 시행하려 하였으나 말초혈관 질환, 관상동맥 우회술 과거력, 중증의 석회화된 대동맥 등의 접근경로상의 문제로 접근이 용이하지 않은 환자였다. 이러한 환자에서 스텐트가 삽입된 장골동맥 협착병변에 경피적 혈관 성형술을 시행 후 성공적으로 TAVI를 시행할 수 있었다. 모든 환자에서 가능한 접근경로에 대한 세심한 평가가 필요하며 이에 따른 적절한 접근경로의 선택 및 시술이 중요하다.

다국어 초록 (Multilingual Abstract)

Transcatheter aortic valve implantation (TAVI) is an alternative treatment modality for surgical aortic valve replacement in patients at high surgical risk. Transfemoral access is not feasible in many cases with unfavorable iliofemoral anatomy or severe peripheral arterial disease (PAD). Elderly patients with severe aortic valve stenosis have a higher prevalence of PAD due to atherosclerotic degenerative changes in the large and small vessels. Transsubclavian, transapical, and direct access to the ascending aorta by thoracotomy are alternative routes for the TAVI procedure. In this case, we describe a patient with a previous coronary artery bypass graft and bilateral iliac artery stenosis who successfully underwent TAVI using a CoreValve® by transfemoral approach after balloon angioplasty of iliac artery stenosis. (Korean J Med 2013;85:188-193)

참고문헌 (Reference)

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