在患有左尾附属物阻塞的患者中,经过过导管 mitra 边缘到边缘修复后的左心室血栓
Kyoko Unno1, Hayato Ohtani1, Atsushi Sakamoto1
1Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Japan.
Internal medicine (Tokyo, Japan)
|November 27, 2024
概括
过导管边缘到边缘修复 (TEER) 对于心肌吐可以导致意想不到的左心房 (LA) 血栓形成,即使在左心房附属物阻塞 (LAAO) 之后. 这一案例凸显了对TEER后血栓形成的警监测的重要性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心血管外科心血管外科
背景情况:
- 心力衰竭 (HF) 的管理往往涉及到解决关节反 (MR).
- 过导管边缘到边缘修复 (TEER) 是严重功能性MR的既定治疗方法.
- 左心房尾阻塞 (LAAO) 用于预防心房的患者中风.
研究的目的:
- 在成功的TEER后报告一个亚急性左心房 (LA) 血栓的病例.
- 讨论可能导致TEER后血栓形成的机制.
- 强调在接受TEER的患者中需要对LA血栓形成保持警,即使之前有LAAO.
主要方法:
- 一个67岁的男性患者的病例报告,患有HF,心房动和以前的LAAO.
- 患者接受了TEER治疗严重的功能性MR.
- 手术后心声扫描显示了一个大LA血栓.
主要成果:
- 进行了成功的TEER.
- 在术后第3天意外发现一个大LA血栓.
- 可能的原因包括改变LA血液动力学,隔膜孔内皮损伤和不充分的抗凝.
结论:
- 亚急性LA血栓是TEER后的潜在并发症.
- 之前的LAAO并不排除TEER后的LA血栓的发展.
- 经过TEER后,仔细监测和优化抗血栓策略至关重要.
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