生物假体大动脉血栓形成,呈现为反复的下壁STEMI
Thitikorn Kittiboonya1, Surakiat Leelasithorn2, Mann Chandavimol2
1Sukumvit Hospital, Bangkok, Thailand.
JACC. Case reports
|January 21, 2026
概括
造成ST升高心肌梗塞 (STEMI) 的假血栓很少见. 这个病例显示了生物假体血栓的延迟诊断,呈现为心肌梗塞与非阻塞性冠状动脉 (MINOCA) 手术后15年.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
背景情况:
- 假血栓是ST段升高心肌梗塞 (STEMI) 的罕见原因.
- 这个病例提出了一个诊断挑战,即假体栓血栓症.
研究的目的:
- 为了突出一种罕见的假动脉血栓形成病例.
- 为了强调诊断挑战和临床影响的晚期呈现生物假体血栓.
主要方法:
- 一名71岁的男性,有生物假体大动脉和 mitra 置换病史,呈现出反复的下壁STEMI.
- 冠状动脉扫描显示了心肌梗塞与非阻塞性冠状动脉 (MINOCA).
- 经食道心声图确定了假动脉上的移动血栓,导致间歇性右冠状动脉骨关闭.
主要成果:
- 患者出现了复发性STEMI,尽管没有显著的冠状动脉狭窄.
- 在假动脉上检测到2厘米的移动血栓.
- 血栓间歇性地堵塞了右冠状动脉.
结论:
- 生物假体栓血栓症可能比通常观察到的时间晚得多,如在这种植入后15年的病例中.
- 门血栓塞应考虑在生物假体门患者呈现血栓事件或MINOCA,无论手术后的时间.
- 通过综合成像,特别是食管横断心声学来进行早期诊断,对于管理假体栓血栓并预防并发症至关重要.
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