人工心脏瓣膜梗阻：溶栓治疗还是手术治疗？
Prosthetic heart valve obstruction: thrombolysis or surgical treatment?
机构信息
Polyclinic General Hospital, Athens, Greece.
出版信息
Eur Heart J Acute Cardiovasc Care. 2012 Jun;1(2):122-7. doi: 10.1177/2048872612451169.
Abstract
Prosthetic valve thrombosis is a potentially life-threatening complication associated with high morbidity and mortality. Transthorasic and transoesophageal echocardiography play an important role to the diagnosis and provides incremental information about the optimal treatment strategy, while fluoroscopy and cardiac computed tomography may be of added value. Guidelines differ on whether surgical treatment or fibrinolysis should be the treatment of choice for the management of left-sided prosthetic valve thrombosis and these uncertainties underline the need for further prospective randomized controlled trials. Thrombus size, New York Heart Association functional class of the patient, the possible contraindications, the availability of each therapeutic option and the clinician's experience are important determinants for the management of prosthetic valve thrombosis.
摘要
人工瓣膜血栓形成是一种潜在危及生命的并发症，与高发病率和死亡率相关。经胸超声心动图和经食管超声心动图对诊断具有重要作用，并提供关于最佳治疗策略的额外信息，而荧光透视和心脏计算机断层扫描可能具有附加价值。指南在左侧人工瓣膜血栓形成的管理中，对于是选择手术治疗还是纤溶治疗存在分歧，这些不确定性突出表明需要进一步进行前瞻性随机对照试验。血栓大小、患者的纽约心脏协会功能分级、可能的禁忌症、每种治疗选择的可用性以及临床医生的经验是人工瓣膜血栓形成管理的重要决定因素。
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