Labèque J N, Laffort P, Lafitte S, Jaïs C, Coste P, Roudaut R
Hôpital cardiologique du Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac.
Arch Mal Coeur Vaiss. 2000 Dec;93(12):1528-33.
Left atrial thrombosis is a serious complication of atrial fibrillation because of its embolic potential, especially for the cerebral circulation. These thrombi are usually treated by oral anticoagulation. The authors studied the efficacy and tolerance of a low molecular weight heparin. Enoxaparin, in the treatment of this condition. This was a prospective study carried out over a 1 year period. Patient recruitment came from the transoesophageal echocardiography laboratory: of 15 thrombi detected, 6 were treated by ambulatory Enoxaparin therapy. Five of the 6 patients had no signs of left atrial thrombosis after 3 weeks of Enoxaparin therapy. The left atrial thrombus of the 6th patient remained hyperechogenic and had decreased in length from 27 to 24 mm. No cases of bleeding, haematoma, embolism or thrombopenia were observed with this treatment. This preliminary study shows that low molecular weight heparin may be used as an alternative to classical oral anticoagulation for the treatment of left atrial thrombosis.
左心房血栓形成是心房颤动的一种严重并发症，因其具有潜在的栓塞风险，尤其是对脑循环而言。这些血栓通常采用口服抗凝治疗。作者研究了低分子量肝素依诺肝素治疗这种病症的疗效和耐受性。这是一项为期1年的前瞻性研究。患者招募自经食管超声心动图实验室：在检测出的15个血栓中，6个采用门诊依诺肝素治疗。6例患者中有5例在接受依诺肝素治疗3周后左心房血栓无迹象。第6例患者的左心房血栓仍为高回声，长度从27毫米降至24毫米。该治疗未观察到出血、血肿、栓塞或血小板减少的病例。这项初步研究表明，低分子量肝素可作为传统口服抗凝治疗左心房血栓形成的替代方法。
