在左心室浮动血栓患者的紧急心脏手术
Olena K Gogayeva1, Oleksandr O Nudchenko1, Yevhenii V Aksonov1
1National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
JACC. Case reports
|January 17, 2025
概括
本案例研究表明,一个患有左心室动脉瘤,浮动血栓和动脉堵塞的患者的手术治疗成功. 仔细规划和稳定的血液动力学是患者的关键.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 一名65岁的患者出现了心力衰竭症状和多种并发症.
- 重要发现包括严重减少的左心室喷射率 (22%),左心室动脉瘤 (LVA) 与大浮动血栓,以及肺高血压.
研究的目的:
- 报告一个复杂的病例的成功手术方法,涉及与浮动血栓和内动脉封闭并发的左心室动脉瘤.
- 强调在高风险的手术患者中精细的术后规划和血液动力学稳定的重要性.
主要方法:
- 冠状动脉旁路移植 (CABG) 结合左心室动脉瘤切除和血栓切除.
- 术前诊断通过心声回声,超声波和计算机断层扫描得到证实.
- 术内管理重点在于在6小时的手术过程中保持血液动力学稳定.
主要成果:
- 通过血栓切除术成功地对多血管冠状动脉疾病和LVA进行手术纠正.
- 手术后恢复没有任何事件,在第10天出院.
- 在5个月的随访中,左心室喷射率改善到42%的症状消失.
结论:
- 这个案例证明了复杂的心血管和脑血管疾病的联合手术策略的可行性和积极结果.
- 通过多学科心脏团队进行仔细的术后管理,对于患有LVA和血栓的高危患者的成功结果至关重要.
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