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真性红细胞增多症患者行冠状动脉旁路移植术时广泛心内血栓形成的处理

Management of extensive intracardiac thombosis in a patient with polycythemia vera undergoing coronary artery bypass grafting.

作者信息

Lima Brian, Soltesz Edward

机构信息

Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio 44195-5108, USA.

出版信息

J Card Surg. 2012 May;27(3):320-2. doi: 10.1111/j.1540-8191.2011.01383.x. Epub 2012 Jan 26.

Abstract

Polycythemia vera (PV) is a chronic myeloproliferative disorder with a predilection for thrombotic complications in affected patients. Intracardiac thrombosis is a rare manifestation of this disease, as documented in only a few published cases. In this report, we describe a PV patient who suddenly developed extensive thrombosis within all four cardiac chambers and severe ventricular dysfunction during a coronary artery bypass procedure. We also detail the intraoperative salvage maneuvers implemented in this case, which included deep hypothermic circulatory arrest with retrocerebral perfusion and four chamber thrombectomy.

摘要

真性红细胞增多症(PV)是一种慢性骨髓增殖性疾病,患病患者易发生血栓并发症。心内血栓形成是该疾病的一种罕见表现,仅有少数已发表病例记载。在本报告中,我们描述了一名PV患者,该患者在冠状动脉搭桥手术期间突然在所有四个心腔内发生广泛血栓形成并出现严重心室功能障碍。我们还详细介绍了该病例中实施的术中挽救措施,包括伴有脑后灌注的深度低温循环停搏和四腔血栓切除术。

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