在没有抗脂抗体的斯内登综合征中经过过导管大动脉置换 (TAVR) 后阻塞性膜血栓形成
Louis Giovachini1, Vincent Pham1, Fabien Picard2
1Department of Cardiology, Hospital Cochin, Paris, France.
BMJ case reports
|June 12, 2023
概括
过导管大动脉置换术 (TAVR) 后的早期阻塞性叶片血栓形成,通过维生素K对抗剂 (VKA) 得到缓解,但在停止治疗后复发. 这凸显了需要识别高风险患者进行抗凝药和早期诊断TAVR传单血栓的必要性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 假体的血栓形成
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见手术.
- 传单血栓是TAVR后的一个潜在并发症.
- 斯内登综合征是一种罕见的疾病,与血栓事件有关.
研究的目的:
- 在TAVR后报告早期阻塞性叶片血栓的病例.
- 讨论TAVR传单血栓瘤的管理和复发.
- 强调识别可能受益于TAVR后抗凝药的患者的重要性.
主要方法:
- 一个患有斯内顿综合征的患者接受TAVR的病例报告.
- 用抗血小板疗法治疗,然后用维生素K抗剂 (VKA).
- 监测跨膜梯度和叶片的移动性.
主要成果:
- 在TAVR后检测到早期阻塞性叶片血栓.
- 血栓瘤通过VKA治疗而消失.
- 在停止VKA治疗后,亚急性血栓复发.
结论:
- 阻塞性TAVR叶片血栓症可能发生在早期,并可能复发.
- 维生素K对手可以有效地管理阻塞性TAVR传单血栓症.
- 系统性抗凝药可能对高风险TAVR患者有益.
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