Wakabayashi Yasushi, Takeuchi Wataru, Yamazaki Kyohei
Department of Cardiovascular Medicine, Nagano Prefectural Kiso Hospital, Nagano, Japan; Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Department of Cardiovascular Medicine, Nagano Prefectural Kiso Hospital, Nagano, Japan.
SAGE Open Med Case Rep. 2015 Jul 14;3:2050313X15595833. doi: 10.1177/2050313X15595833. eCollection 2015.
Inferior vena cava filters are effective for preventing the passage of thrombi into the pulmonary arteries in patients with pulmonary embolism and deep vein thrombosis. These filters are indicated in patients with contraindications to anticoagulant therapy or in patients with recurrent acute pulmonary embolism despite the administration of anticoagulant therapy. However, the occurrence of filter-related complications, such as filter migration to the heart, has been increasing. Herein, we report a case of OptEase inferior vena cava filter misplacement in the right atrium. Although the filter migrated to the right ventricle, it was successfully removed and repositioned in the inferior vena cava using endovascular techniques. Unfortunately, moderate tricuspid regurgitation developed, due to the damage to the tricuspid valve that was caused by the procedure. We have also reviewed the relevant literature and discussed the possible strategies for managing cases of filter migration to the heart and preventing filter misplacement.
下腔静脉滤器对于预防肺栓塞和深静脉血栓形成患者的血栓进入肺动脉是有效的。这些滤器适用于抗凝治疗有禁忌证的患者或尽管进行了抗凝治疗仍反复发生急性肺栓塞的患者。然而，滤器相关并发症的发生，如滤器迁移至心脏，一直在增加。在此，我们报告一例OptEase下腔静脉滤器误置于右心房的病例。尽管滤器迁移至右心室，但通过血管内技术成功将其取出并重新放置在下腔静脉中。不幸的是，由于手术导致三尖瓣受损，出现了中度三尖瓣反流。我们还回顾了相关文献，并讨论了处理滤器迁移至心脏病例和预防滤器误置的可能策略。
