晚期发病的左心房附属体封闭装置相关的血栓,归因于 mitra bioprosthetic 狭窄症:一个病例报告
Aakash Rana1, Jack Xu2, Hani Alturkmani3
1Central Arkansas Veterans Affairs Health System, 4300, W 7th Street, Little Rock, AR 72205, USA.
European heart journal. Case reports
|September 11, 2024
概括
延迟与器件相关的血栓 (DRT) 可以发生在左心房附属物阻塞 (LAAO) 后,心房动和恶化的 mitra bioprosthetic 狭窄症患者. 这一案例凸显了在如此复杂的心血管情景中需要对DRT进行警监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 左心房尾阻塞 (LAAO) 是一种已确定的中风预防策略,用于心房动 (AF) 患者.
- 假肢心肌病可以使AF管理和中风风险评估复杂化.
- 设备相关的血栓 (DRT) 是LAAO的已知并发症,通常在术后较早发生.
研究的目的:
- 报告一个罕见的晚发器件相关血栓 (DRT) 病例,该病例是在左心房附属体封闭 (LAAO) 之后发生的.
- 突出DRT在患有共存假体中狭窄症的患者中潜在的风险因素和临床影响.
- 强调心声回声监测在LAAO患者和 mitra 生物假体疾病患者的重要性.
主要方法:
- 一份病例报告详细介绍了一名69岁的女性患者的临床过程,患有神经发作性AF,并有生物假体中枢置换病史.
- 由于反复出现的胃肠道出血而使用Watchman Flx设备进行了穿皮LAAO.
- 连续通过食道和胸心声图被用于监测设备功能,周围设备泄漏和血栓形成.
主要成果:
- 一名69岁的女性有生物假体关节置换病史,成功接受了LAAO.
- 在LAAO后13个月,在心声学上检测到大量的DRT,这与 mitra bioprosthetic狭窄症和左心房静止症的恶化相吻合.
- 抗凝固疗法导致DRT的解决,允许随后成功地进行跨导管中门中门更换.
结论:
- 假肢心肌狭窄症的恶化可能导致左心房静止和功能障碍的增加,作为LAAO后晚期DRT的危险因素.
- 带有LAAO设备和额头生理假体的患者需要加强对假体门功能和延迟DRT的心声监测.
- 需要进一步的研究来评估LAAO设备的安全性和最佳管理策略,这些策略适用于患有 mitra bioprosthetic 疾病的患者.
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