机械瓣膜梗阻：诊断与治疗策略综述
Mechanical valve obstruction: Review of diagnostic and treatment strategies.
作者信息
Salamon Jason, Munoz-Mendoza Jerson, Liebelt Jared J, Taub Cynthia C
机构信息
Jason Salamon, Jerson Munoz-Mendoza, Cynthia C Taub, Department of Cardiology, Montefiore Medical Center, Bronx, NY 10467, United States.
出版信息
World J Cardiol. 2015 Dec 26;7(12):875-81. doi: 10.4330/wjc.v7.i12.875.
Abstract
Prosthetic valve obstruction (PVO) is a rare but feared complication of mechanical valve replacement. Diagnostic evaluation should focus on differentiating prosthetic valve thrombosis (PVT) from pannus formation, as their treatment options differ. History of sub-optimal anti-coagulation and post-op time course to development of PVO are useful clinical characteristics in differentiating thrombus from pannus formation. Treatment of PVT is influenced by the patient's symptoms, valve location, degree of obstruction and thrombus size and may include thrombolysis or surgical intervention. Alternatively, pannus formation requires surgical intervention. The purpose of this article is to review the pathophysiology, epidemiology, diagnostic approach and treatment options for aortic and mitral valve PVO.
摘要
人工瓣膜阻塞（PVO）是机械瓣膜置换术后一种罕见但令人担忧的并发症。诊断评估应着重于区分人工瓣膜血栓形成（PVT）与血管翳形成，因为它们的治疗方案不同。抗凝效果欠佳的病史以及PVO发生的术后时间进程是区分血栓与血管翳形成的有用临床特征。PVT的治疗受患者症状、瓣膜位置、阻塞程度和血栓大小的影响，可能包括溶栓或手术干预。或者，血管翳形成则需要手术干预。本文的目的是综述主动脉瓣和二尖瓣PVO的病理生理学、流行病学、诊断方法及治疗选择。
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