Aykan Ahmet, Oguz Ali, Yildiz Mustafa, Özkan Mehmet
Department of Cardiology, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.
Cardiovasc J Afr. 2012 Jul 12;23(6):e14-5. doi: 10.5830/CVJA-2011-070.
Every year nearly 300 000 patients have heart valve operations and mostly prosthetic valves are inserted. Coumadin is the mainstay of therapy in these individuals but it has many side effects, mostly related to its anticoagulant effect. Rectus sheath haematoma (RSH) is a rare complication of abdominal trauma, surgery and excessive strain, however, anticoagulant agents may predispose to this condition without any precipitating event. Reversal of anticoagulation and resuscitation with fluids and blood products are necessary but anticoagulation is crucial in patients with prosthetic valves, as they have acquired thrombotic diathesis. Herein we report on a case of spontaneous RSH in a patient with prosthetic mitral and aortic valves and a history of prosthetic valve thrombosis. He was successfully managed medically.
每年有近30万名患者接受心脏瓣膜手术，大多数植入的是人工瓣膜。华法林是这些患者治疗的主要药物，但它有许多副作用，大多与其抗凝作用有关。腹直肌鞘血肿（RSH）是腹部创伤、手术及过度用力后的一种罕见并发症，然而，抗凝剂可能在无任何促发事件的情况下使患者易患此病。抗凝作用的逆转以及液体和血液制品的复苏是必要的，但对于有人工瓣膜的患者，抗凝至关重要，因为他们已形成血栓形成素质。在此，我们报告一例患有二尖瓣和主动脉瓣人工瓣膜且有人工瓣膜血栓形成病史的患者发生自发性腹直肌鞘血肿的病例。他通过药物治疗成功康复。
