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与海德综合征相关的血管扩张是否自发消失? :一个案例报告报告
Rui Li1, Shuliang Ji2, Jiaxi Shi3
1Department of Cardiovascular Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou, China.
Journal of cardiothoracic surgery
|July 10, 2023
概括
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科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
背景情况:
- 由于症状重叠和检查局限性,海德综合征存在诊断挑战.
- 在海德综合征患者中,由于抗凝血-静血冲突,延迟的大动脉置换是常见的.
- 非典型的海德综合征可以表现为严重的,耐火性胃肠道出血.
研究的目的:
- 报告一种罕见的非典型的海德综合征病例.
- 为了突出重度胃肠道出血的成功管理,用跨导管大动脉植入器 (TAVI).
主要方法:
- 一名64岁的女性患有耐火性胃肠道出血和大动脉狭窄症,接受了TAVI.
- 由于出血,最初的肠切除术并没有完全消除症状.
- 在复发出血和确定大动脉狭窄后,考虑对海德综合征的诊断.
主要成果:
- 胃肠道出血在TAVI后显著改善.
- 在2年的随访期间,该患者没有出现严重的缺血或出血事件.
- 在TAVI时,血管扫描没有显示出血管扩张症或获得的·威勒布兰德综合征 (AVWS).
结论:
- 海德综合征的临床诊断不应仅仅依赖于可见的血管扩张或特定的·维勒布兰德因子 (vWF) 水平.
- 肠切除术可以作为一项临时措施,用于在主动脉置换之前严重出血.
- 对于患有海德综合征的高风险患者来说,TAVI是一种可行的选择,即使有出血风险.
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