急性三状叶片血栓在跨导管三状的修复过程中
Dalila Nappa1, Maria Luisa Salido-Tahoces2, Ana García-Martín2
1Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
JACC. Case reports
|November 7, 2025
概括
透导管三门修复 (TTVR) 可能会造成急性血栓形成的风险. 通过实时成像指导的机械吸血,在抗凝药失败时有效地解决了凝块,允许成功完成TTVR.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 透导管三门修复 (TTVR) 是一种新兴的治疗方法,用于高风险患者严重的三回.
- 在TTVR期间的手术内血栓事件是不常见但严重的并发症.
- 严重的功能性三管吐需要先进的治疗干预措施.
研究的目的:
- 在TTVR期间报告一种罕见的急性血栓形成病例.
- 为了说明在TTVR期间手术内血栓的管理.
- 强调实时成像和机械愿望在TTVR并发症中的作用.
主要方法:
- 一名80岁的女性患者患有心房动和严重的功能性三管吐,接受了边缘到边缘的TTVR.
- 尽管有治疗性抗凝药,但在装置部署期间形成了急性移动血栓.
- 经食道心声学和心内心声学指导机械血栓吸收.
主要成果:
- 在导管定位过程中形成了急性移动血栓,迁移到三叶片.
- 额外的氨酸给药在解决血栓方面无效.
- 在成像指导下,成功实现了血栓的机械吸收.
- TTVR手术顺利完成,患者在稳定的状态下出院.
结论:
- 在TTVR期间,即使有足够的抗凝药,急性血栓形成也是潜在的风险.
- 实时心内和食管内心声谱对于检测和管理手术内并发症至关重要.
- 机械吸血是一种有效的策略,用于管理血栓,当抗凝剂在TTVR期间失败时.
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