左心房附属体血栓与严重的 mitra 狭窄:对抗凝血药物反应和不反应者
Tariq Ashraf1, Kanwal Fatima Aamir2, Asif Nadeem3
1Karachi Institute of Heart Diseases, Karachi, Pakistan.
概括
抗凝固药物解决了左心房附属体 (LAA) 血栓,仅在27.3%的严重心肌狭窄患者中. 仙人掌LAA形态和LAA尖端血栓显示出更好的反应,这表明了量身定制的治疗方法.
科学领域:
- 心脏病学 心脏病学
- 血管医学 血管医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 副心膜狭窄症 (MS) 是一种常见的膜性心脏病,特别是在发展中国家.
- 抗凝剂在不同LAA形态的左心房附属体 (LAA) 血栓的解决中的有效性尚不清楚.
研究的目的:
- 在患有严重多发性硬化症的患者接受抗凝药治疗三个月后,研究LAA血栓的解脱率.
- 根据LAA形态和血栓位置来评估血栓分辨率.
主要方法:
- 一项前性队列研究,涉及88名患有严重多发性硬化症的患者.
- 经食道心声学 (TEE) 用于评估在华法林治疗三个月之前和之后的LAA血栓.
- 基线LAA形态通过心脏计算机断层扫描来确定.
主要成果:
- 在27.3%的患者中观察到整体血栓解脱.
- "仙人掌"的LAA形态 (66.7%分辨率) 和LAA尖端的瘤 (62.5%分辨率) 显示出更高的响应率.
- "花菜"和"翅"LAA形态的分辨率较低,LAA基部 (0%分辨率) 和体 (9.1%分辨率) 中的瘤.
结论:
- "仙人掌"的LAA形态和LAA尖端血栓对抗凝固有好反应.
- 在LAA基/体中发生血栓或具有"花菜"/"翅"形态的患者可能没有反应,可能需要早期手术干预.
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