右心室血栓复杂化LVAD候选:一个临床案例研究
Cetin Alak1, Aarti Desai1, Abdallah El-Sabbagh2
1Division of Heart Failure and Transplantation, Mayo Clinic, Jacksonville, FL 32224, USA.
Journal of clinical medicine
|September 13, 2025
概括
穿皮结血切除术在等待左心室辅助器件 (LVAD) 的高风险患者中有效地切除了右心房血栓. 这种侵入性较小的手术降低了栓塞风险,并促进了安全的LVAD植入.
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:
- 右心房血栓 (RAT) 是罕见的,但与高死亡率和栓塞风险相关.
- 由于高的手术风险,RAT使左心室辅助器件 (LVAD) 候选人的管理复杂化.
- 透皮血栓切除术提供了一个不那么侵入性的替代手术以移除RAT.
研究的目的:
- 评估皮肤穿血栓切除术作为LVAD植入的桥梁的疗效.
- 为了证明在高风险患者中管理右心房血栓的少入侵方法.
主要方法:
- 一名76岁的患有缺血性心肌病和心力衰竭的男性使用AngioVac系统进行皮肤穿透性血栓切除术,用于大,移动的右心房血栓.
- 该患者计划进行LVAD植入.
主要成果:
- 通过皮肤输血管切除术成功切除右心房血栓.
- 患者在抗凝血药物阿皮克萨班的治疗下出院.
- 在35天的恢复延迟后,LVAD植入安全地进行了.
结论:
- 穿皮结血切除术是一种有效的桥梁治疗方法,适用于患有右心房血栓的LVAD候选人.
- 这种方法最大限度地减少了血栓栓塞并发症,并支持在高风险人群中随后的LVAD植入.
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