在一个复杂的门内的TAVR中阻塞性低衰减的叶片加厚被成功用血栓溶解治疗
Dhan Bahadur Shrestha1, Ashlesha Chaudhary2, Unaib Memon2
1Division of Cardiology, Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA.
JACC. Case reports
|February 11, 2026
概括
低衰减叶片加厚 (HALT) 是生物假体功能障碍的关键原因. 使用血栓溶解和抗凝剂的医学治疗可以在高风险患者中成功治疗阻塞性HALT.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 低衰减的叶片加厚 (HALT) 是经过过导管大动脉置换 (TAVR) 后生物假体功能障碍的重要原因.
- 区分HALT与结构退化对于适当的管理至关重要.
研究的目的:
- 在复杂的TAVR程序后呈现阻塞性HALT的情况.
- 评估HALT治疗药物疗法的有效性,在患有重手术风险过高的患者中.
主要方法:
- 在TAVR5年后,一个患有运动性呼吸不全和胸部紧张的患者通过心声学和CT血管学诊断出了HALT.
- 治疗涉及48小时的超慢,低剂量阿尔泰拉斯输注,随后是阿皮克萨班治疗.
主要成果:
- 患者的假体门功能显著改善,平均梯度从66mmHg降低到28mmHg.
- 在治疗期间或治疗后没有报告任何重大不良事件.
结论:
- 阻塞性HALT可以通过超缓慢,低剂量血栓溶解和随后的抗凝药有效治疗.
- 医疗治疗为选择的高风险患者提供了安全的替代方案,以避免重复手术.
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