Cáceres-Lóriga Fidel Manuel, Pérez-López Horacio, Santos-Gracia José, Morlans-Hernandez Karel
Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba.
Int J Cardiol. 2006 Jun 7;110(1):1-6. doi: 10.1016/j.ijcard.2005.06.051. Epub 2005 Jul 20.
Thrombosis of a prosthetic valve is one of the most severe complications of cardiac valve replacement. The incidence is 0.5% in the aortic and mitral positions and up to 20% in the tricuspid position. The presenting clinical picture ranges from the absence of symptoms to cardiogenic shock. The traditional treatment of this complication has been emergency surgery, but thrombolysis, which has been available for many years, is being considered as the first line of treatment more and more every day. The pathogenesis, diagnosis and treatment of thrombosis of prosthetic heart valves are reviewed here. Thrombolysis, which has an efficacy of over 80%, is emphasized in this review. Embolic complications associated with this therapeutic approach remain a great concern with rates of 3% to 10%, and some authors reporting rates up to 20%.
人工瓣膜血栓形成是心脏瓣膜置换术后最严重的并发症之一。主动脉瓣和二尖瓣位的发生率为0.5%，三尖瓣位高达20%。临床表现从无症状到心源性休克不等。这种并发症的传统治疗方法是急诊手术，但已应用多年的溶栓疗法正日益被视为一线治疗方法。本文综述人工心脏瓣膜血栓形成的发病机制、诊断和治疗。本综述强调溶栓疗法，其有效率超过80%。与这种治疗方法相关的栓塞并发症仍然是一个重大问题，发生率为3%至10%，一些作者报告的发生率高达20%。
