Yokoyama Y, Satoh H, Kurata A, Otani T, Fujieda H, Abe Y, Abe M
Department of Cardiovascular Surgery, Yotsuba Circulation Clinic, Matsuyama, Japan.
Kyobu Geka. 2009 Mar;62(3):238-40.
Native aortic valve thrombosis is an uncommon event. We describe the case of a 76-year-old man who suffered acute myocardial infarction associated with native aortic valve thrombosis diagnosed by cardiac catheterization. Since the thrombus was localized on the right coronary cusp and occluded right coronary artery, rescue revascularization was performed using perfusion catheter, which was continuously engaged to the right coronary artery. Operation was immediately performed under cardiopulmonary bypass. After incision of ascending aorta, thrombus was removed easily and aortic valve was preserved without degenerative change. Histological study showed a typical thrombus without any specific findings. He had a good clinical course and discharged 9 days after the operation. He had no history of heart valve disease, left heart catheterization or bacterial endocarditis. Since laboratory data showed 41% in protein C antigen and 32% of protein C activity, he was diagnosed of protein C deficiency. Our report emphasize that this thrombus formation may be caused by protein C deficiency.
原发性主动脉瓣血栓形成是一种罕见的事件。我们描述了一名76岁男性的病例，该患者因心脏导管检查诊断为原发性主动脉瓣血栓形成并发急性心肌梗死。由于血栓位于右冠状动脉瓣叶并阻塞了右冠状动脉，遂使用灌注导管进行了挽救性血运重建，该导管持续接入右冠状动脉。立即在体外循环下进行手术。切开升主动脉后，血栓很容易被清除，主动脉瓣得以保留且无退行性改变。组织学研究显示为典型血栓，无任何特异性表现。他的临床过程良好，术后9天出院。他既往无心脏瓣膜病、左心导管检查或细菌性心内膜炎病史。由于实验室数据显示蛋白C抗原为41%，蛋白C活性为32%，他被诊断为蛋白C缺乏症。我们的报告强调，这种血栓形成可能是由蛋白C缺乏引起的。
