Campisi Salvatore, Fuzellier Jean-Francois, Vola Marco, Favre Jean-Pierre
Department of Cardiovascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.
Department of Cardiovascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.
Ann Thorac Surg. 2014 Dec;98(6):e143-5. doi: 10.1016/j.athoracsur.2014.08.054. Epub 2014 Dec 1.
A 33-year-old man underwent urgent coronary artery de-obstruction for acute thrombotic occlusion of the left descending coronary artery. After 10 days of antiplatelet and heparin therapy, ventriculographic and echocardiographic control revealed a giant thrombus in the left ventricle, an ejection fraction of 40%, and severe mitral regurgitation. Heparin-induced thrombocytopenia was diagnosed. After urgent mitral valve annuloplasty and left ventricular thrombectomy, the patient was discharged. In the literature, several cases of right atrial and ventricular thrombi have been described; however, to the best of our knowledge, this is the first report of giant left ventricular thrombus during heparin-induced thrombocytopenia.
一名33岁男性因左冠状动脉前降支急性血栓闭塞接受了紧急冠状动脉疏通术。在接受10天的抗血小板和肝素治疗后,心室造影和超声心动图检查发现左心室内有巨大血栓,射血分数为40%,并伴有严重二尖瓣反流。诊断为肝素诱导的血小板减少症。在紧急进行二尖瓣环成形术和左心室血栓切除术之后,患者出院。文献中已有数例右心房和右心室血栓的报道;然而,据我们所知,这是首例关于肝素诱导的血小板减少症期间出现巨大左心室血栓的报告。